I’m so glad you’re here.

This form is simply a way for me to get to know you better before we connect. Only your name and email are required—everything else is optional.

There are no wrong answers, and no pressure to share everything right now. If you’re low on energy or focus, just fill out what’s speaking to you. You can also download the PDF version and email it to me at heather@thebridgeworkproject.com if that’s more your style.

Take your time. We’ll begin where you are.

Name

First Name

Last Name

Email

Pronouns

Preferred way to connect

Tell me a bit about what brought you here.

Do you have any accessibility, processing, or communication preferences you’d like me to know?

Have you worked with a couch (professional or personal) in the past?

Yes

No

If yes, how did that experience feel for you? What worked? What didn’t?

Bridgework Intake Form

I’m so glad you’re here.