Pre-Appointment Questionnaire

Where are you in your life right now?
Where do you want to go?

Please complete my pre-appointment questionnaire so that I can assess your current situation and determine if I can add value to your life. Thank you.

Please rate your feelings on the following on a 1 (low) to 10 (high) scale:

Thank you for your interest in working with Dr. Rajiv Parti. Rest assured, your responses to this survey will be kept confidential.