First Name
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Last Name
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Email
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How would you describe your current professional role or context?
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What specific challenges are you currently facing?
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Have you participated in therapy before? If yes, please briefly describe your experience.
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What are you hoping to achieve through working with Melina?
I understand that Melina's practice is private, application-based, and utilizes structured containers/packages.
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Note: All information provided will be kept strictly confidential