Filling Out Your Consultation Questionnaire

In preparation for your Dynamic Emotional Integration® consultation (also known as DEI), please fill out and submit this questionnaire.

Your information — here and in your DEI consultation — will remain confidential.

The information you provide here will help me understand your emotional strengths and challenges, the current socio-emotional situations you’re dealing with, and the supportive resources you have in your life. I look forward to learning more about you!

Your DEI Consultation Questionnaire

  • As you answer these questions, treat them as a snapshot of your current situation, behavior, skills, challenges, and resources - so that we can focus clearly on your present-day situation. Thank you!
  • About Your Situation

  • About You

  • About Your Support System

  • About This Consultation



Thank you! You will receive a copy of your answers by e-mail.

I look forward to speaking with you soon!