Initial Consultation Form – Roxana Cristina Alexandru

Begin With a Conversation

Thank you for taking the step to begin a conversation.

Before scheduling the initial consultation, you are invited to complete this short form. This offers an opportunity to share a little about what brings you here and helps me prepare for our conversation.

You are welcome to answer as much or as little as feels comfortable.

About You

Full Name

Email Address

Phone Number (optional)

Date of Birth

Home Address

City / Country of Residence

Your Reasons for Reaching Out

What has brought you to seek support at this time?

What are you hoping support through counselling may offer you at this time?

Have you previously experienced therapy or counselling?

Yes No

If yes, you are welcome to share a little about what that experience was like for you.

Practical Details

Which type of session are you interested in?

Online counselling Walk and Talk therapy Reflective astrology consultation Not sure yet

Do you have any preferred days or times for sessions?

Are you currently receiving any form of therapeutic or mental health support?

No Yes, therapy or counselling Yes, medical or psychiatric support Prefer not to say

Before Our Conversation

Is there anything you would like me to know about you before we meet?

Support Needs

Are you currently experiencing circumstances that may require urgent or crisis support?

No Yes Prefer not to say

If you are experiencing a mental health crisis or require urgent support, please contact your GP, local crisis service or emergency services. This practice does not provide crisis support.

Consent

I understand that the initial consultation is a 30-minute online conversation intended to explore whether working together feels like a good fit.

I understand and agree

Privacy Notice

Personal information shared through this form is stored securely and processed in accordance with UK data protection law. Roxana Cristina Alexandru is registered as a data controller with the Information Commissioner’s Office.

I consent to my information being processed for the purpose of providing counselling services.

By submitting this form, you consent to your information being used to respond to your enquiry and provide services in accordance with the Privacy Policy.

Astrology Consultation Form

Reflective Astrology

Thank you for your interest in an astrology consultation.

This short form gathers the information needed to prepare your natal chart and offers an opportunity to share what you would like the session to explore.

My approach to astrology is reflective rather than predictive, using the chart as a tool for insight, self-understanding and meaningful reflection.