Behavior/Health/Training Intake

Please complete the following intake form, and I will be in touch within 48 business hours.

NOTE: As I am in 12 client homes per week, many of which include people at high risk of serious illness, I am continuing to ask all of my clients to mask for all inside training activities with me. When we are outside, you may remove your mask if you wish. I appreciate all of my clients helping me to keep all of my clients safe.

Note - all questions with an * are required. Use the TAB button or your cursor to jump to another question - avoid using the 'enter' button.