Consultation Questionnaire Extraordinaire!
Hello!!! So happy you found me and are doing what you can to improve your relationships! Lets see what we can do to make them even better!
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Email *
Name *
Today's Date *
MM
/
DD
/
YYYY
Birthday
MM
/
DD
/
YYYY
Phone *
In a relationship? *
NO? 
Tell me about your desired relationship.  Length? Open? Monogamous? Polyamorous? Etc? 

YES? 
Tell me about your current relationship and your desires within that relationship. Length? Open? Monogamous? Polyamorous? Etc?
*
How can I help? 
What brings you here? 
What changes do you need to make?
*
What are your goals, dreams and aspirations? 
Both relationally and personally.
*
What have you already tried? Tell me about your self development journey. *
What’s working? *
What’s not working? *
How connected do you feel to your body? *
Not very... I feel uncomfortable in my body. It feels painful or numb.
Very! I know how to listen to it and understand what it's telling me. I feel at home in my body.
How did you find me? *
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