New Client Intake Form
Welcome!

Filling out forms isn't fun, but I promise to do my best to keep the information collected to only what I truly consider useful, and essential on behalf of Your Financial Therapist.

Here's a quick rundown of how this will work:

--> Provide some basic information about yourself (name, phone number, etc.)
--> Agree to my financial therapy terms, policies, and procedures (the legal stuff)
--> Fill me in on your reasons for seeking financial counseling

Legal note: Before you begin filling out this form, please be sure YOU AGREE AND CONSENT that by submitting this form electronically, as well as typing your name and click on the final "submit" button this will be used as your electronic signature.

That's it!  Please start below by entering an email address that is unique to you (i.e not a shared email address). For couples, each person must complete their own New Client Intake Form.

Thank you!

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Privacy and Confidentiality
Your email address and responses will remain confidential. I will not disclose ANY client information without your written consent, UNLESS disclosure is is required to protect your welfare, the welfare of others, or is required by law. When disclosure is required, only information that is essential is revealed, and you will be informed of such disclosure.
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