"We cannot shame ourselves into change - we can only love ourselves into evolution"



Intake Form

Whether you’ve already scheduled your consultation or are just getting started, you’re in the right place.



This brief form helps us understand your needs and match you with a therapist who best aligns with you.

                                                                             Before You Begin

If you’ve already scheduled a consultation:
Complete this form prior to your appointment. No need to book again.


If you have not scheduled a consultation yet:
After submitting this form, you’ll be prompted to schedule your consultation.

info@liveconsciouslypllc.com

(254) 826-9450