Intake form

Thank you for your interest in scheduling a Holding Space Consultation.

In preparation for your upcoming Holding Space Consultation, please answer the following questions. Your responses will be confidentially held ~ just as details shared during your consultation are held in confidence. 

  1. Briefly describe what led you to reach out for consultation. Feel free to include details about the nature of the difficulties/loss(es)/life transitions that you would like to focus on during your 50-minute consultation.
  2. Be sure to let us know which US state or which country you live in. Also, share any personal details relevant to your experiences that feels important for your consultant to know (e.g., aspects of identity, personal values and beliefs, loss history, etc.).
  3. State which days you are available and if you are available morning (8am-noon EST), afternoon (noon-4pm EST), or evening (4pm-8pm EST).
  4. If you have an interest in arranging a Holding Space Consultation with a particular consultant, please let us know.

Send your responses to the following questions to: 



*Confidentiality is held within legal and ethical limits.