Embrace Your Space

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Embrace Your Space

Kindly take a moment to thoughtfully answer the questions below. I invite you to get curious, ask questions, and share your aspirations for what you hope to gain from our time together. Additionally, any personal insights or details you're comfortable sharing will be held, heard, and honored. Following your submission, we will organize a 15 minute Discovery Zoom Call to further explore, discuss, and ascertain if our energies align. Thank you for your courage, vulnerability is the first step towards truth, trust, and transformation..

Email *

Record my email address with my response

First name *

Last name *

Email *

Phone number *

How did you hear about me? *

Location *

I wish to visit your temple

I wish to provide my own temple space

What offerings are you most curious about? *

Discovery Call

Sacred Bodywork

Intimacy Coaching

Conscious Cuddling

Somatic Embodiment

Other:

Required

Are there any health-related concerns or conditions that I should be informed about?
*

What struggles have you previously endured or are presently confronting?
*

Anorgasmia

Sexual trauma

Lack of intimacy

Erectile Dysfunction

Premature Ejaculation

Other:

Required

Do you have any additional questions or concerns that you would like to share with me?

Are you willing to complete the verification process necessary to be considered for a session and agree to all of the terms and conditions?
*

Yes

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms