Quick Booking Would you like to start a booking now? Then please complete these six short questions, to help us create your appointment. Name Email Phone New or Returning Client? 1 What are your therapy needs? Relationship Issue Public Speaking Anger Management PTSD Weight Loss Managing Anxiety or Stress Improving Confidence Resolving a Fear or Phobia Eradicating Outdated Habits Mindfulness and Relaxation Other Issue 1 out of 6 2 How would you like to receive your therapy, online or at Diana's home clinic? In person, at Diana's clinic Skype WhatsApp FaceTime Audio Only 2 out of 6 3 Choose one or more days that are best for your appointment? Mondays Tuesdays Wednesdays Thursdays Fridays 3 out of 6 4 Choose one or more times that are most convenient for you? Mornings from 11am Early afternoon 12:00 till 3pm Late afternoon 3pm till 6pm Evening 6pm till 8pm 4 out of 6 5 What are you hoping to achieve with this therapy? 5 out of 6 6 How would you like Diana to contact you with the booking information? Text Email I accept the Privacy Policy of this questionnaire 6 out of 6 Time is Up! Time's up
