Welcome!To help me understand your needs, please fill out the form below before your first appointment. Name * First Name Last Name Pronouns Birthdate MM DD YYYY Email * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country What are you currently struggling with? Have you had CranioSacral Therapy before? Yes No What other modalities have you tried to resolve your issue? * How did you hear about me? Thank you.I appreciate you taking the time to tell me a little bit about yourself. Online forms are helpful, but the real work starts when we meet in person. If there’s anything you’d like to add, clarify, or talk more about, feel free to send me an email. We’ll take some time at the beginning of our first session to connect and go over everything more thoroughly.Whatever you’re going through, I promise you’re not alone.