P.O.P. Strategy Session – Intake Form

Step 1: About You

Full Name *

Email *

Phone *

Step 2: Licensing Information

Are you a currently licensed mental health professional? *

Yes

Your License Type (e.g., LMFT, LCSW, LPC, Psychologist): *

State(s) of Licensure: *

Step 3: Business Stage

Which best describes your current private practice stage? *

I’m just getting started and haven’t launched yet

I have a few clients but want to grow

I’m fully booked but feel stuck or overwhelmed

I’m ready to scale and build a legacy

What is your biggest challenge right now in your practice? *

Step 4: Next Steps

What would you love to get out of this P.O.P. Strategy Session? *