Mini Coaching Sessions with Yana!
Hello & Welcome!

Please fill out this form to reserve your mini-coaching session slot. I will confirm your appointment via email and when your coaching time arrives, I'll video-call you via Skype or GoogleChat (your choice!).

Looking forward to working with you and see you soon,

*
Yana Tallon-Hicks, MA

Individual & Relationships Therapist

Couples Center of the Pioneer Valley, Northampton, MA | Soma Wellness Center, Brattleboro, VT

Pleasure-Positive Sex Educator & Writer | yanatallonhicks.com

{She/Her Pronouns}

Your Name: *
Your answer
Your Email: *
Your answer
Your pronouns (she/her, he/him, they/them, etc.)
Your answer
Partner Name/s & Pronouns (if applicable)
Your answer
Are all parties at least 18 years old? *
Have to be, sorry.
Do you prefer GoogleChat or Skype? *
Your Skype or GoogleChat username: *
I will video call you at our agreed upon time! At this point, voice-only (non-video call) is not an option for safety reasons.
Your answer
Mini Coaching Sessions cost $40 for 30 minutes. How would you like to pay? *
Which appointment times are you interested in? *
All times are listed in Eastern Standard Time (EST). I will email you to confirm your slot ASAP!
Required
What would you like to discuss during your session?
Brief is better // Do you have a goal in mind? Let me know so I can help us stay focused!
Your answer
Check here to confirm the following: 1) that you are 18 years old or older 2) to acknowledge that coaching sessions are not therapy and are designed to provide information, direction, and motivation 3) your privacy, session contents, and personal information will be kept secure & confidential 4) all fees are non-refundable *
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