Contact me now for information or an intake session

Email me at info@headandheartwork.nl or use the contact form (below). Our correspondence is confidential, so please don’t use your work email address. In addition to your name and private email address, please provide your private phone number, so that I can call you to make an initial appointment. If I can’t reach you, my email reply will include all my availability in the next few weeks.

Download the relevant form:

intake form for individual therapy & counseling

intake form for couple relationship therapy & counseling

Fully complete the form, then send it in editable docx format (not pdf, please) to: info@headandheartwork.nl

– Clearly describe in relevant detail the problems currently troubling you, as well as the concise history of how they arose.
– Clearly define positive, specific and realistic goals: the desired emotional state, thoughts and behaviours.

Concerned about security? Email me the completed form in password-protected format and text the password to +31640475088.

No waiting list

We can schedule a daytime or evening intake session within a week or two to get to know each other, establish a ‘click’ and clarify the core problem(s) and goal(s) for the therapy. If you have more than one problem, we will set priorities. We will also discuss whether your goals are realistic and the steps to take to reach them. Then the head and heart work can begin.

If we conclude that another therapist or a specialist would be more suitable, I will refer you to a fully qualified and experienced professional in the region.

address:

Mgr. v.d. Weteringstraat 14a
3581EH Utrecht, Netherlands

e-mail:

info@headandheartwork.nl

phone:

+31640475088 (mobile)

contact hours:

10:00 – 19:00  Monday to Thursday

Contact form

NB: Only to be used by potential clients for therapy, counseling or coaching.
All messages offering products or services will be ignored.
I process the information obtained through this contact form in full accordance with the provisions of the EU General Data Protection Regulation (GDPR).
Read my privacy policy >.

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