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Questionnaire

As part of my consultation, I ask clients to complete the following questionnaire prior to my visit. Upon receipt of the completed questionnaire, I’ll call to arrange for an appointment. All answers remain confidential. While the client information is required, clients only need to respond to those questions they feel comfortable with responding to. Obviously, the more responses, the better the consultation. Couples should complete the questionnaire separately and share responses with each other after they’ve e-mailed them to me.


Read the Terms of Service here.

Please respond to as many of the following questions as you feel comfortable with. Couples should complete independently and share responses after sending the form.
















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Script by Dagon Design

Posted by admin on July 29th, 2009

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