Request a Consultation | Private Sessions

Welcome. I am delighted that you would like to schedule a complimentary session to talk about the possibility of working together.

You matter to me.

That is why I ask you to fill out the questionnaire below. This will help me prepare for our session, and begin the process of discerning if I am the right alternative therapist and coach for you. Once I have reviewed the information you provide, I’ll reach out to you to schedule our consultation.

Please know that whatever you are experiencing, there is a path to feeling good. I look forward to exploring that with you.

Warmly, 
Rachel

I believe everyone should have an equal opportunity to thrive, no matter their income. For this reason I offer my Pink Bottle Sliding Scale pricing method, where you get to decide what works best for you.

Please fill out the information below. All of your information is confidential.

Name

Phone number

City & State

Time Zone

How did you hear about me? Please provide the name of the person or platform who referred / introduced you.

What would you like me to know about you?  Age, marital status, child/ren, profession, ethnicity. Share what feels good.

Are you currently Pregnant or postpartum?

Yes

If yes, please share more.

Why are you seeking professional support?

What is going well in your life right now?

What are you most struggling with?

If we work together, how do you want to feel six months from now?

Have you done other kinds of coaching, therapy, healing programs, group programs, etc? Please share what you’ve explored in the past and why you sought those out.

How is your current state affecting your relationships, work, finances, sexuality and health?

What else would you like me to know about you? (Trauma, abuse, accidents, injuries, illness, religious or spiritual beliefs, losses, etc)

On a scale of 1-10 how committed are you to resolving your struggle and making the changes that are necessary for you to feel better? (1 being 'Not Committed' and 10 being 'So Committed!')

Have you read all of the content on my website that describes my private services, including the Pink Bottle Sliding Scale payment options?

Yes

How do you prefer to be contacted?

Phone

Text

Are you available to meet Monday through Friday between the hours of 7am-2pm Pacific / 10am - 5pm Eastern?

Welcome. I am delighted that you would like to schedule a complimentary session to talk about the possibility of working together.

Please fill out the information below. All of your information is confidential.

Thank you for completing this questionnaire. Rachel will contact you as soon as she has reviewed the information you have provided.

Join Our Free Trial