Couples Intake Form

Before your initial consultation

These questions help me understand you, your relationship history and what brings you here. If you’d prefer to explore something in session, simply note this on the form.

I treat your form as confidential between you and me, and I will not refer to anything in your form when we meet. However, when working with two people, I cannot hold significant secrets. If one partner shares something the other doesn’t know and they have no intention of disclosing it to them, couple work would need to stop and I would need to refer you to individual therapists to ensure our work remains ethical and safe.

Before committing to working together, please ensure you’ve carefully read the  Therapeutic Contract as it explains important terms and boundaries that underpin our work together.

If you have any questions, please get in touch with me hello@michaelamurphy.co.uk

For details on data protection please see my GDPR policy.