Yoni Steam Intake Form
Yoni steaming is an ancient practice used to help women at various stages of their lives. Thank you for giving me the opportunity to help you on your journey. This intake form is to help me make a steam just for you and your body. Please answer as truthful as possible.

Once I receive your responses, I will then send you an invoice, along with information on the steam, and set up I recommend for you. Your kit will be mailed 72 hours (or sooner) after receipt of payment.  If we are meeting for an in studio session, I look forward to seeing you soon.

Please take some time to visit my Etsy shop at https://www.etsy.com/shop/ReconnectwithEnergy

If you have any additional questions, you can call me at 224-423-5433 or my email is katrinadowen@gmail.com 

Thank you for your support
Email *
Your Name *
Your Email
Your Mailing Address
Contraindications : There are times when it is not beneficial for a woman to steam. Do any of the following apply to your current situation? *
Not Sure
Currently on your Period
Active Spotting
Have you had spontaneous bleeding within past 3 months
Are you pregnant
Are you trying to conceive and it is AFTER your date of ovulation or IUI/IVF Transfer
Did you answer YES to any of the Contraindications? If so which one?
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