Humanize L.L.C New Client Inquiry Form

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Client Information

Humanize LLC is a company driven by its mission to enhance connections between providers and clients and within themselves. Our approach prioritizes the human experience, embracing the complexities that come with it. Our clients will be empowered to transform their creativity, promoting authenticity, compassion, and honesty. Additionally, we believe in giving back to the community, and we do so by providing scholarships to underprivileged students.

First name

Last name

Age

Phone Number

Email Address

Humanize Hours Of Practice Please indicate what days might work for your schedule

Tuesday 7am to 3pm

Wednesday 7am to 3pm

Thursday 7am to 3pm

Friday 7am to 10am

Possible Times

My appointments are 45 minutes, and start on the hour

Humanize believes in transparency and values agency over one's decision; therefore, I understand the following:

All sessions are Telehealth only, Humanize LLC does not provide In-Person sessions, and all clients must be physically located in the state of Massachusetts, Florida or South Carolina when services are rendered.

Humanize LLC requires a card on file for all client's

Humanize LLC Requires 24-hour cancelation for all sessions having a late cancelation fee of $160 for individuals and $200 for couples

Booking a consultation does not guarantee services

Have you been in therapy before? If so what did you enjoy or dislike?

Any previously held diagnosis?

What would you like me to know about you before our call?

Following this form, a link to my Calendly will populate where you can schedule your consultation

Optional food for thought: When do you feel most like you?

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