PAIGE BARTHOLOMEW
  • Counseling
    • Trauma
    • What is this work?
    • About Paige
    • Therapy for Awakening
    • Rates and Insurance
  • Couples
  • Chronic Pain and Illness
  • THE SOUL MAP Book
    • The Seven Levels Explained

New Client Intake Form

Welcome to counseling!  This form will help me get to know your personality, your deep needs for healing and your goals for therapy.  It will also hopefully give you more insight into yourself, and what you would like to get out of your personal journey. Thank you for taking the time to give proper consideration to your answers.
Paige

    Please describe in detail what has brought you for counseling.
    Describe your parents' relationship with each other. Describe your relationship with each parent. Describe your relationship with each of your siblings.
    Please list the counseling, healings, psychiatric treatment, and medications you've currently used in your lifetime to help you.














    Insurance Information



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  • Counseling
    • Trauma
    • What is this work?
    • About Paige
    • Therapy for Awakening
    • Rates and Insurance
  • Couples
  • Chronic Pain and Illness
  • THE SOUL MAP Book
    • The Seven Levels Explained