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Personal data

Thank you for your help!

Please fill in the form below for me. I need to collect the data for legal and practical reasons so that I can contact you, for example, if changes need to be made to the agreed session.

EN - Terms, personal info

Before filling out the form below to request an initial consultation, please read through the following information:


The terms and conditions of my services, inluding:

 

Please note that,

  • An initial consultation is charged at the standard price of a regular session
  • I do not offer sessions in the evenings after 5:30pm or at weekends
  • I only work with clients over 17 years of age
 
 

e.g. Dear

e.g. Dear

Please enter your date of birth below. Tip: the year can be changed by clicking on it and using the two arrows that appear in order to adjust the value.

Please enter the names of all family members who will be attending sessions and their e-mail addresses. You can add further family members by clicking the plus symbol to the right of the row.

 

Please enter your partner's name and e-mail address

Information regarding referrals and recommendations


Availability for sessions

Please give me information here about your availability to come to sessions. If you are interested in a service where there are will be more than one person present, the following questions apply to all persons involved.


Unfortunately owing to the high demand for sessions at this time, I can only offer  sessions after 4 p.m. on an infrequent basis

Session frequency

Frequency at which you would like to visit sessions.

Note: Psychotherapy research indicates that shorter session intervals (every 1-2 weeks)  are beneficial for successful therapy outcomes. For coaching and supervision, intervals can be longer, depending on the topic. 


You have indicated that you are only available for sessions after 4 p.m. which I can unfortunately only offer on an infrequent basis owing to the high demand for this time.  Please consider this when selecting the option below.

If it is difficult for you to make it to my office regularly, please remember that I do offer sessions online in order to help here. 

I am currently not able to offer weekly sessions after 4 p.m. Please revise your answers above.

I am currently not able to offer sessions every two weeks after 4 p.m. Please revise your answers above.