A completed questionnaire is required for ALL  potential clients prior to scheduling.

Questions noted with a * MUST be answered in order to send this form. 

Please answer the following questions in as much detail as possible & note that I do not respond to incomplete questionnaires

I highly suggest making a protonmail email account prior to submitting this questionnaire to ensure that our communication is encrypted &, thus, completely private. This service is free & an account can be easily acquired in just a few minutes. Visit www.protonmail.com.

If you experience problems submitting my questionnaire, you may send an email containing the necessary information instead.  

General questions/correspondence should be sent to mirandarider@protonmail.com.

 

Click Here To View My Privacy Policy

Powered byEMF HTML Contact Form