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Womb Healing Consultation

Thank you for your interest in working with me.

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The care I offer is slow, body-based, and participatory. It is not a quick treatment, and it is not a passive service where healing is done to you.

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Before scheduling a consultation, I ask each woman to complete this questionnaire. I personally review each submission to determine whether my work is appropriate for you at this time.

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This is not a medical intake form. It is a readiness and compatibility form.

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If I feel I am the right practitioner for you, you will receive an invitation to schedule a consultation conversation. If not, I may recommend a different type of support first.

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Please answer honestly and thoughtfully.

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-Yèyẹ́sìndé

Which of the following are you currently experiencing? (Check all that apply)
How long has this been affecting you?
What types of help have you already tried?
After an emotionally difficult experience, how long does it usually take you to feel settled again?
Do you feel your body is holding onto something that has not been processed or released?
Which statement best describes your understanding of this type of work?
This work may bring up emotions, memories, or realizations. How prepared do you feel for that?
When working with a practitioner or helper in the past, which experience have you had most often?
Outside of scheduled sessions, what level of communication do you feel you need from a practitioner?
Are you currently in therapy or receiving mental health care?
Are you currently experiencing severe emotional distress, crisis, or thoughts of harming yourself?
My services are private pay and not covered by insurance. Are you prepared to invest in care if accepted?
Do you have consistent time available for sessions and follow-through practices?
Are you seeking:
I personally review each submission. If I feel I am the appropriate practitioner for you at this time, you will receive an invitation to schedule a consultation conversation. Submission of this form does not automatically schedule an appointment.
I acknowledge
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