"Clean up your room first, fix the world later."

This form is designed to gather important information that will help us shape our therapy process to best fit your needs. Some questions on our form are optional and will help us gain a deeper understanding of you. While filling out these questions is optional, sharing your experiences and feelings provides me with a valuable opportunity to create the most effective and personalized therapy plan for you. This information will be kept completely confidential and will only be used to support your therapy process. It should take approximately 5 minutes to complete this form.

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