client intake form

Somatics and dance-movement therapy

private sessions

come exactly as you are

After you submit this intake form, it will be emailed directly to Helen and she will be in touch shortly. You will also be connected to a WhatsApp chat with Helen to say hello!

Full name

First Name

Last Name

Preferred name

Mobile

Country

(###)

###

####

You are welcome to add a brief message here. However once we connect, you will be given the opportunity to share information relevant to your personal circumstances and forming a safe and confidential Client/Therapist alliance.