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Take the
First Step

Autism symptoms are presenting for:
ADHD symptoms are presenting for:
The topics that we want to work on during the retreat are:
For our retreat experience, we are interested in:
Where do you reside? (This impacts whether you are matched with a neurodiverse therapist or a neurodiverse coach.)
Your therapist or coach preferences:
Are you also interested in an ASD Assessment and/or Diagnosis?
Incorporate spirituality?
After the retreat, we offer follow-up therapy. Our therapy fee per 50 minute session varies based on life experience, clinical experience, training, education (master's, doctorate), and special certifications. Please indicate the fee you are able to pay and we will do our best to match you with the appropriate professional.

Information shared on this intake form may be viewed by members of the Neurodiverse Retreat staff in order to match you with the retreat therapist who is the best fit for you.   By entering your information, you will be added to our mailing list however you will be given the option to unsubscribe at any time.  

Beautiful Landscape
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