New Client Information

Please complete the New Client Information prior to our first session. You may fill out the form below or download it as a Word doc here.

Name*
First Last
Today's Date*
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Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Cell*
Date of Birth*
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Birth Time

: Hours

Minutes
Initial reason for seeking support*
What is your highest hope in doing this inner work?*
Would you like to be added to my email list?
- Yes, please add me!
My philosophy is a gentle, practical approach that incorporates cognitive, holistic and energy psychologies. Sometimes the frameworks I use are simple and easily understood and sometimes they are more ethereal in nature. Please let me know if you need more clarification the next day after a session.

Please allow me at least 24 hours notice if you need to change or cancel an appointment to avoid being charged for a missed session. I can be reached by text or phone on my cell 617-233-4251 or by email at LotusFlowerLiving@gmail.com.

Lotus Flower Living is a specialized spiritual methodology. While I have many certificates of study and a Masters in Counseling and Psychology, the philosophy and methodology I use are strictly my own opinion and approach to transformation. I am not a traditional, licensed Psychologist. I am an independent energy practitioner specializing in “clearing work” and spiritual practices. Please take what works for you and leave the rest.
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