Wilding Therapy — New Client Inquiry.

Hello, I’m so happy you are here. Whether you are new to therapy or have been working with a therapist for a while, I’m here to support you. I offer a free 30-minute consultation to see if we are a good fit for your needs.

This form helps us both determine if we’re a good fit. I specialize in long-term, trauma-informed, somatic, and nature-rooted therapy for people ready to do deep inner work, explore themselves fully, and reconnect with their authentic selves.

You don’t need to have all the answers — just answer as honestly as you can. This helps ensure that our work together is safe, meaningful, and aligned with your needs. Once you submit the form, I will reach out to you within 48 hours to set up a consultation time. I look forward to meeting you.

Nicole…

Name

First Name

Last Name

Preferred Method of Contact

Call

Text

Additional Info

Let us know what time or day works best in your schedule, as well as anything else you think we should know:

How do you prefer your free consultation?

In Person

Over the Phone

Online Video Call

What brings you to therapy right now?

Text What are your goals for therapy?

Are you open to exploring patterns in yourself, your relationships, and your emotions, even when it feels uncomfortable? (Not everyone is ready — it’s okay to be honest!)

Are you interested in long-term therapy (3+ months or ongoing)?

How many sessions per month can you realistically commit to?

Are you able to invest financially in regular therapy sessions? I do offer a sliding scale for those in need.

Yes I am

No, not right now.

Is there anything else you’d like me to know to determine if we’re a good fit?

Please do not include any Protected Health Information (PHI) when using this form.