Name *

First Name

Last Name

Phone

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Please note that my trauma coaching services are time-limited, unlike traditional therapy and that my per session fee is $500. Unfortunately I don't have sliding scale slots available and can only take my full fee. If in agreement, please check "Yes I am aware of your fee and agree to compensate your full fee for your coaching service." Thank you for understanding and for wanting to work with me. *

Yes, I am aware of your fee and agree to pay your full fee for this coaching service.