{"id":1422,"date":"2022-03-24T10:52:48","date_gmt":"2022-03-24T14:52:48","guid":{"rendered":"https:\/\/heatherveltman.com\/pre-meeting-form\/"},"modified":"2022-06-20T13:46:19","modified_gmt":"2022-06-20T17:46:19","slug":"pre-meeting-form","status":"publish","type":"page","link":"https:\/\/heatherveltman.com\/en\/pre-meeting-form\/","title":{"rendered":"Pre-meeting form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1422\" class=\"elementor elementor-1422 elementor-945\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-870e11d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"870e11d\" data-element_type=\"section\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-156d320\" data-id=\"156d320\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0b71233 elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"0b71233\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.16.0 - 09-10-2023 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h2 class=\"elementor-heading-title elementor-size-default\">Pre-meeting form<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-734bde6 elementor-widget elementor-widget-text-editor\" data-id=\"734bde6\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.16.0 - 09-10-2023 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p>Thank you for completing this form prior to our first meeting. This will allow me to speed up the evaluation process to create a personalized service that corresponds to your needs. <\/p><p> <\/p><p>You will have access to my calendar to choose a date for our first meeting. <\/p><p> <\/p><p>All the information in this form is strictly confidential. I am the only person who will have access to this document. We will discuss this further during our appointment.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-10234c1 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"10234c1\" data-element_type=\"section\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-61e87f5\" data-id=\"61e87f5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4ea7d47 elementor-button-align-center elementor-widget elementor-widget-form\" data-id=\"4ea7d47\" data-element_type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;step_type&quot;:&quot;number&quot;,&quot;step_icon_shape&quot;:&quot;none&quot;,&quot;button_width&quot;:&quot;100&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor-pro - v3.16.0 - 20-09-2023 *\/\n.elementor-button.elementor-hidden,.elementor-hidden{display:none}.e-form__step{width:100%}.e-form__step:not(.elementor-hidden){display:flex;flex-wrap:wrap}.e-form__buttons{flex-wrap:wrap}.e-form__buttons,.e-form__buttons__wrapper{display:flex}.e-form__indicators{display:flex;justify-content:space-between;align-items:center;flex-wrap:nowrap;font-size:13px;margin-bottom:var(--e-form-steps-indicators-spacing)}.e-form__indicators__indicator{display:flex;flex-direction:column;align-items:center;justify-content:center;flex-basis:0;padding:0 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.e-form__indicators__indicator__separator,.e-form__indicators--type-number .e-form__indicators__indicator__separator,.e-form__indicators--type-number_text .e-form__indicators__indicator__separator{margin-top:calc(var(--e-form-steps-indicator-padding, 30px) \/ 2 - var(--e-form-steps-divider-width, 1px) \/ 2)}.elementor-field-type-hidden{display:none}.elementor-field-type-html{display:inline-block}.elementor-login .elementor-lost-password,.elementor-login .elementor-remember-me{font-size:.85em}.elementor-field-type-recaptcha_v3 .elementor-field-label{display:none}.elementor-field-type-recaptcha_v3 .grecaptcha-badge{z-index:1}.elementor-button .elementor-form-spinner{order:3}.elementor-form .elementor-button>span{display:flex;justify-content:center;align-items:center}.elementor-form .elementor-button .elementor-button-text{white-space:normal;flex-grow:0}.elementor-form .elementor-button svg{height:auto}.elementor-form .elementor-button .e-font-icon-svg{height:1em}.elementor-select-wrapper .select-caret-down-wrapper{position:absolute;top:50%;transform:translateY(-50%);inset-inline-end:10px;pointer-events:none;font-size:11px}.elementor-select-wrapper .select-caret-down-wrapper svg{display:unset;width:1em;aspect-ratio:unset;fill:currentColor}.elementor-select-wrapper .select-caret-down-wrapper i{font-size:19px;line-height:2}.elementor-select-wrapper.remove-before:before{content:\"\"!important}<\/style>\t\t<form class=\"elementor-form\" method=\"post\" id=\"prerencontre\" name=\"Pre-meeting form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"1422\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"4ea7d47\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Dr. Heather Veltman\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-page1 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Page 1\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-prenom elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-prenom\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFirst name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[prenom]\" id=\"form-field-prenom\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"First name\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-nom elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-nom\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tLast name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[nom]\" id=\"form-field-nom\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Last name\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-tel elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-tel\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[tel]\" id=\"form-field-tel\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Phone number\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Email\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-adresse elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-adresse\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAddress\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[adresse]\" id=\"form-field-adresse\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Address\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-profession elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-profession\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tOccupation\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[profession]\" id=\"form-field-profession\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Occupation\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-couple elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-couple\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tRelationship status\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[couple]\" id=\"form-field-couple\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"If in a relationship, since when\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-enfant elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-enfant\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tChildren\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[enfant]\" id=\"form-field-enfant\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"If so, their age and gender\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-trouvee elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-trouvee\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHow did you find me?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[trouvee]\" id=\"form-field-trouvee\" class=\"elementor-field-textual elementor-size-lg\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Select...<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Facebook\">Facebook<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Instagram\">Instagram<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Google\">Google<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Website\">Website<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Personal reference\">Personal reference<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Other\">Other<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-page2 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Page 2\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-objectif elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-objectif\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tObjectives, I want to: (check the box and elaborate)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Better love my female body\" id=\"form-field-objectif-0\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-0\">Better love my female body<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Feel beautiful\" id=\"form-field-objectif-1\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-1\">Feel beautiful<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Improve my self-esteem\" id=\"form-field-objectif-2\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-2\">Improve my self-esteem<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Manage my anxiety\" id=\"form-field-objectif-3\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-3\">Manage my anxiety<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Experience joy\" id=\"form-field-objectif-4\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-4\">Experience joy<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Become empowered\" id=\"form-field-objectif-5\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-5\">Become empowered<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Learn to say no (or yes!)\" id=\"form-field-objectif-6\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-6\">Learn to say no (or yes!)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Develop my creativity and my artistic sense\" id=\"form-field-objectif-7\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-7\">Develop my creativity and my artistic sense<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Find clarity in my projects and dreams\" id=\"form-field-objectif-8\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-8\">Find clarity in my projects and dreams<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Fall in love with myself or others\" id=\"form-field-objectif-9\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-9\">Fall in love with myself or others<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Deepen my intimacy skills\" id=\"form-field-objectif-10\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-10\">Deepen my intimacy skills<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Other (please describe)\" id=\"form-field-objectif-11\" name=\"form_fields[objectif][]\"> <label for=\"form-field-objectif-11\">Other (please describe)<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_18da280 elementor-col-50\">\n\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-lg\" name=\"form_fields[field_18da280]\" id=\"form-field-field_18da280\" rows=\"2\" placeholder=\"Elaborate your choices\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-symptome elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-symptome\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSymptoms related to my difficulties or my challenges\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-lg\" name=\"form_fields[symptome]\" id=\"form-field-symptome\" rows=\"3\" placeholder=\"Please describe\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-contexte elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-contexte\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tContext and history of the problem\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-lg\" name=\"form_fields[contexte]\" id=\"form-field-contexte\" rows=\"3\" placeholder=\"When, how it happens and since when\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-histoire elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-histoire\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFamily history\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-lg\" name=\"form_fields[histoire]\" id=\"form-field-histoire\" rows=\"3\" placeholder=\"Please briefly describe your family dynamics: the relationships with your mother, your father and\/or your siblings\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-conditionmed elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-conditionmed\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMedical condition or diagnosis \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-lg\" name=\"form_fields[conditionmed]\" id=\"form-field-conditionmed\" rows=\"3\" placeholder=\"Medical condition or diagnosis \"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-medicaments elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-medicaments\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMedication \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-lg\" name=\"form_fields[medicaments]\" id=\"form-field-medicaments\" rows=\"3\" placeholder=\"Please indicate for what condition\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-consul_anterieur elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-consul_anterieur\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPrior consultations in psychotherapy \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-lg\" name=\"form_fields[consul_anterieur]\" id=\"form-field-consul_anterieur\" rows=\"3\" placeholder=\"Please describe positive or negative experiences\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-page3 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Page 3\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_b796748 elementor-col-100\">\n\t\t\t\t\t<h4 style=\"text-align:center;\">Lifestyle: help me understand how you live and your life habits<\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_caa7908 elementor-col-100\">\n\t\t\t\t\t<h5 style=\"color:#F58981; text-align:center\">Interpersonal relationships<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-orientation elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-orientation\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSexual orientation\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[orientation]\" id=\"form-field-orientation\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Sexual orientation\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-social elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-social\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCircle of friends and social life\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[social]\" id=\"form-field-social\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"How many friends and what is the frequency of their visits?\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-couple elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-couple\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCouple\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[couple]\" id=\"form-field-couple\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Is it harmonious, distant or conflictual?\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-vie_intime elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-vie_intime\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tQuality of intimacy and sexual life \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[vie_intime]\" id=\"form-field-vie_intime\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Is it good or insufficient?\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-famille elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-famille\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tContact with family members\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[famille]\" id=\"form-field-famille\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Frequency?\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_1ebe7ab elementor-col-100\">\n\t\t\t\t\t<h5 style=\"color:#F58981; text-align:center\">Health <\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-sport elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-sport\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tExercice\/sports\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[sport]\" id=\"form-field-sport\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Types of activities and frequency per week\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-alimentation elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-alimentation\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNutrition\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[alimentation]\" id=\"form-field-alimentation\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Do you eat 3 balanced meals a day?\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-prob_alim elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-prob_alim\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEating disorder\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[prob_alim]\" id=\"form-field-prob_alim\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"If yes, what is the disorder?\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-sommeil elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-sommeil\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSleeping habits\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[sommeil]\" id=\"form-field-sommeil\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Sleeping habits \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-corps elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-corps\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo you like your body?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[corps]\" id=\"form-field-corps\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"On a scale of 1 to 10\" min=\"1\" max=\"10\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_b135901 elementor-col-100\">\n\t\t\t\t\t<h5 style=\"color:#F58981; text-align:center\">Addictions<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-cigarettes elementor-col-20\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-cigarettes\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCigarettes\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-cigarettes-0\" name=\"form_fields[cigarettes]\"> <label for=\"form-field-cigarettes-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-cigarettes-1\" name=\"form_fields[cigarettes]\"> <label for=\"form-field-cigarettes-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-alcool elementor-col-20\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-alcool\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAlcohol\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-alcool-0\" name=\"form_fields[alcool]\"> <label for=\"form-field-alcool-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-alcool-1\" name=\"form_fields[alcool]\"> <label for=\"form-field-alcool-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-drogues elementor-col-20\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-drogues\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDrugs\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-drogues-0\" name=\"form_fields[drogues]\"> <label for=\"form-field-drogues-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-drogues-1\" name=\"form_fields[drogues]\"> <label for=\"form-field-drogues-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-dependances elementor-col-40\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-dependances\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tOther addictions\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[dependances]\" id=\"form-field-dependances\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"If so, which ones?\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_c0d7e5f elementor-col-100\">\n\t\t\t\t\t<h5 style=\"color:#F58981; text-align:center\">Traumas<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-harcelement elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-harcelement\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tVictim of harassment or sexual assault\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[harcelement]\" id=\"form-field-harcelement\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Victim of harassment or sexual assault\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-pensees elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-pensees\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSuicidal thoughts\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[pensees]\" id=\"form-field-pensees\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Please give an example\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-peurs elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-peurs\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFears\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[peurs]\" id=\"form-field-peurs\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Fears \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-estime elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-estime\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEvaluation of your self-esteem\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[estime]\" id=\"form-field-estime\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"On a scale of 1 to 10\" min=\"1\" max=\"10\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-autres elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-autres\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tOther\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[autres]\" id=\"form-field-autres\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Other\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-page4 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Page 4\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_391cfac elementor-col-100\">\n\t\t\t\t\t<h4 style=\"text-align:center;\">Is there anything else you would like me to know? <\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-sache elementor-col-100\">\n\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-lg\" name=\"form_fields[sache]\" id=\"form-field-sache\" rows=\"4\" placeholder=\"Is there anything else you would like me to know? \"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_ef81640 elementor-col-75\">\n\t\t\t\t\t<p style=\"font-style: italic;\">In some cases, I might not be able to initiate psychotherapy with you. If that is the case, I will do my best to refer you to a professional who can best meet your needs and goals.<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-annulation elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[annulation]\" id=\"form-field-annulation\" class=\"elementor-field elementor-size-lg  elementor-acceptance-field\" required=\"required\" aria-required=\"true\">\n\t\t\t\t<label for=\"form-field-annulation\">I understand and accept <a href=\"https:\/\/heatherveltman.com\/en\/faq\/\" target=\"_blank\">the cancellation policy.<\/a> <\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-retard elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[retard]\" id=\"form-field-retard\" class=\"elementor-field elementor-size-lg  elementor-acceptance-field\" required=\"required\" aria-required=\"true\">\n\t\t\t\t<label for=\"form-field-retard\">I understand and accept <a href=\"https:\/\/heatherveltman.com\/en\/faq\/\" target=\"_blank\">the late policy.<\/a> <\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-telepratique elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[telepratique]\" id=\"form-field-telepratique\" class=\"elementor-field elementor-size-lg  elementor-acceptance-field\" required=\"required\" aria-required=\"true\">\n\t\t\t\t<label for=\"form-field-telepratique\">I understand and accept teletherapy and I take responsibility for my part in ensuring confidentiality (erasing data, wearing a headset, choosing a private area). <\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-limites elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[limites]\" id=\"form-field-limites\" class=\"elementor-field elementor-size-lg  elementor-acceptance-field\" required=\"required\" aria-required=\"true\">\n\t\t\t\t<label for=\"form-field-limites\">I understand and accept the limits of existential-humanist psychotherapy. This means that Dr. Veltman will refer me in the event of an emergency or to another professional if necessary.<\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-consentement elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[consentement]\" id=\"form-field-consentement\" class=\"elementor-field elementor-size-lg  elementor-acceptance-field\" required=\"required\" aria-required=\"true\">\n\t\t\t\t<label for=\"form-field-consentement\">I give my free and informed consent to begin a therapeutic process with Dr. Veltman. I can revoke my consent at any time and request termination.<\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button type=\"submit\" class=\"elementor-button elementor-size-md\">\n\t\t\t\t\t\t<span >\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\" elementor-button-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Pre-meeting form Thank you for completing this form prior to our first meeting. This will allow me to speed up the evaluation process to create a personalized service that corresponds to your needs. You will have access to my calendar to choose a date for our first meeting. All the information in this form is [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":1563,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Pre-meeting form - Dr. Heather Veltman<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/heatherveltman.com\/en\/pre-meeting-form\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pre-meeting form - Dr. Heather Veltman\" \/>\n<meta property=\"og:description\" content=\"Pre-meeting form Thank you for completing this form prior to our first meeting. This will allow me to speed up the evaluation process to create a personalized service that corresponds to your needs. You will have access to my calendar to choose a date for our first meeting. 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