Intake form

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

Please send your responses to the following questions to: consultations@birthbreathanddeath.com 

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

  1. Please briefly describe what led you to reach out for consultation at this particular point in time. If you would like, 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. Please 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. If you have any particular hopes, preferences or requests for how you can be most supported during your forthcoming consultation, please share them here.

 If you have an interest in arranging a Holding Space Consultation on a particular day/time or with a particular consultant, please let us know. We understand that level of fit is extremely important and it helps us to know when you feel drawn to a particular consultant so that we can support you even more fully.

 

*Please know that confidentiality is held within legal and ethical limits.