Please share a brief description (for example: anxiety, sleep, focus, life transitions). Please do not include your full medical or trauma history here; we can discuss details with you privately during your intake.

By submitting this form, you consent to be contacted by Mindful Living Group LLC using the phone, text, and/or email you provide to discuss scheduling and care options. Please do not include highly sensitive medical details in this form; more detailed information will be collected during your intake. This form is not monitored 24/7 and should not be used for emergencies. If you are experiencing a life‑threatening emergency, call 911 immediately, or for a mental health crisis call or text 988 for support.

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