Intake Form
Provide only the contact details you’re comfortable with me using to send information to, and complete as many fields as you are comfortable to at this stage:
Please enter as DD-MM-YYYY
e.g. what prompted you to enquire, is there a specific intention you’d like to work with, issue you’d like to address or aspect of your sexual experience you would like to work on changing? Please give a brief outline…
Check all that apply
e.g. sessions with...personal fitness trainer, psychotherapist, CBT practitioner, erotic bodywork experience such as sexological bodyworker, sensual massage, sex worker, surrogate, tantrika, other, Rolfing bodywork, deep tissue massage, reiki etc.
e.g. the area(s) of learning/growth that you want to focus on first. What will feel/be different after these sessions?