top of page

Final Step to Your Wellness Journey

We are so glad you've taken this brave step. This intake form is the final part of our preparation, allowing us to understand your background and goals so our counseling session can be as effective and supportive as possible. Your privacy and comfort are our priority.

Client Intake Details

Clinical Intake Form

Welcome. Please complete this form before your first appointment. All information is kept strictly confidential.

Reminder: Please ensure you are in a quiet, private space for our consultation to maintain your emotional safety and focus.

What Happens Next

Thank you for taking the time to share these details. Dr. Roopam will personally review your intake responses to prepare for our upcoming session. Within the next 24-48 hours, you will receive a confirmation email with finalized session details and the digital link for our video consultation. This ensures our time together is focused entirely on your path to wellness.

bottom of page