Mentoring & Supervision for Professionals
Use this form to begin the process of working together. You usually get a response the same day.
Name ( First and Last) *
email ( **please** check as one wrong letter means I cannot reply to you) *
Location (city / country) *
How did you hear about me? *
Did you read the Mentoring & Supervision for Professionals page? *
I recognize you have options in choosing a professional to work with, and I'm not your average practitioner. To be sure we are well suited, describe what resonated about my work and why you have selected me. *
What's your professional background e.g. psychologist, doctor, counselor, body worker etc? *
What kind of sexological study & training have you undertaken to date? *
Are you seeking support for yourself or with a group? *
Briefly describe what would you like to work on with me? *
What hesitations do you have, if any, about working together at this time? *
If you don't hear back within 48 hours, check your junk mail *
This is your personal email - not work or school (sometimes filters block my emails from work and school servers because they contain the word sex) *
Please indicate your affiliation with any of these communities/ identities/practices *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy