This form is designed to be simple and conversational.

You'll see one question at a time, and as you answer each one, the next will automatically appear. It should only take a few minutes to complete — and your responses will help me understand your needs, goals, and whether this support service is the right fit.

Take your time, answer honestly, and if you’re filling this out on behalf of a loved one, feel free to answer from their perspective. Thank you and I look forward to helping you any way that I can.