This form is designed to collect important personal information about you/your child and the reasons you are seeking counselling. It will take approximately 15 minutes to complete. Completing this form before your appointment will allow us more time, during the session, for discussion and goal setting. Some of the questions may cause you some emotional discomfort, so please, if you prefer to discuss something during your first session, you are welcome to leave that section blank. Please click next at the bottom of each page to save your responses as you complete the form.