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Personal Information Form. Mentorship/ Coaching / Body work ~ with Ananda

Dear seeker,

I am honored that you have chosen to work with me in this profound healing space of transformation. Please take some time to answer the questions below. These will assist me in getting to know you better and will also help you clarify your intentions, priorities, and any boundaries you may have. I treat the information you provide as confidential, and what you share here will be kept between the two of us.

After reviewing your form, you will receive a link to book your first session. If I have any questions, I will reach out to check in with you.

In Love,devotion and gratitude.

Ananda

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Name & Surname *
E-mail address *
Phone number / whatsapp *
Your body identification *
What experience do you have (if any) receiving coaching / sexual healing work? *
What other personal growth work have you done ?
Are you in one or more intimate relationship/s?
What is your profession or form of work ?
What field of interest are you passionate about ?
Do you take any medications?
Do you have any physical pains at the moment, chronic pains or any resent surgery ?
Please share any recent major life events: deaths, break ups, trauma, business/career changes or other emotional transitions. If you are not sure whether or not to include something, please do! *
Please list any relevant medical history including any episodes of, including non-treated episodes, or medication for, psychiatric or emotional conditions. (e.g. depression, anxiety, psychosis, obsessive compulsive behaviour, eating disorders, addiction).
Do you have a history of abuse; physical, sexual, emotional, verbal? *
Is self pleasure part of your life? If so, how?
Do you already know of something specific you want to work on/with, explore, transform, learn? *
What do you feel is currently the biggest obstacle or blockage on your path?
Imagine we are on the other side of the session/program, what have you walked away with, what have you gained, how do you feel? *
Anything else you would like me to know?
"I understand that these sessions are not meant as therapy and that I am fully responsible for the outcome of the session, that is for my own healing and  receiving what I come for". *
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