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Client Intake Form

Please take the time to fill this form in and tell your story. The information you give helps us get the results you want. We will also use this form to reassess the progress you make and the outcomes you gain from working with us. This form is a great tool for helping you gain a clear perspective of what you are contending with. This form will remain strictly confidential.

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  • Just a few more questions that can help us to provide a better service to all of our clients, thank you.

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