Coaching Intake Form

Answer as many questions as you are comfortable with at this stage. We can go into more detail during your intake call if needed. Please answer as fully as you can: the form is an important step in clarifying why it is that you are interested in coaching, and how the sessions can support you. All information shared is confidential.

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?