Privacy Notice: The information you provide in this consultation form—such as your contact details, brief history, and what you’re seeking support for—helps me determine whether my services are a good fit and to prepare for our initial conversation. I use this information only for scheduling, communication, and assessing appropriateness for services, and I do not share or sell it. Your information is kept private and stored in secure, HIPAA-compliant systems. Please know there are legal limits to confidentiality, including concerns about harm to yourself or others, or suspected abuse or neglect of a child, elderly, or vulnerable adult. Completing this form does not create a therapist–client relationship, but if we begin working together, all health information will be fully protected under HIPAA and Tennessee confidentiality laws.