Family Intake

Tell me about your family

This helps me understand your child and your day-to-day before we work together. It takes about 15–20 minutes — there are no wrong answers, and you can be as brief or detailed as you like.

Before we begin

Family intake questionnaire

Work through it at your own pace — your progress shows at the top. Only your name and your child's name are required; skip anything that doesn't apply.

Step 1 of 7 - Family & Home

This field is for validation purposes and should be left unchanged.

Family & Home

Include all children, adults, and anyone who regularly provides care
How would you describe your family's typical energy level at home?
Walk me through it as if I were watching a movie of your day. Don't worry about making it sound organized.
e.g. new baby, move, separation, job change, loss, new school