Name *

Name

First Name

Last Name

Date *

Date

YYYY

Email Address *

Email OK? *

Yes

Phone *

Phone

(###)

###

####

VM OK? *

Yes

How did you hear about me? *

About Somatic Sex Coaching

Whatever your motivation for deepening into your erotic self, ALL OF YOU is welcome here. Somatic sex coaching sessions are built on a foundation of professionalism, clear consent and well defined boundaries to ensure the safety, comfort and efficacy of the work we’ll do together. Hands-on touch, inclusive of genital and anal touch, are offered at the request of the student and when deemed appropriate by the practitioner. This touch will always be in service to your learning experience, one-directional (from practitioner to student) and will keep physical safety and hygiene as a top priority alongside your spiritual and emotional well being.

About You

Gender *

Pronoun(s) *

Date of birth *

Date of birth

YYYY

Sexual orientation *

Relationship orientation *

Single

Dating

Partnered

Other

Monogamous

Polyamorous

Monogamish

Undefined

Current partners (please include their gender, age and length of relationship) *

Children & ages *

Spiritual and/or Religious Influence(s) *

In your own words, what is your intention for seeking somatic sex coaching? *

Please describe what is currently most gratifying about your intimate life *

Please describe what is currently most challenging about your intimate life. *

What does your support system look like? This can include practitioners, therapists, community connections, partners, lovers, friends, family and other resources you have to help you integrate this exploration should you need that. *

Your Sex Story

Please briefly describe your history, attitudes and/or experiences of the following topics. You may select only those that feel most relevant to your intention for this work and there will of course be time for us to talk more in depth during your session.

Your relationship to you body

Your upbringing

Partnered Sex

Solo Sex/Masturbation

Peak erotic experience(s)/biggest turn-ons

Orgasm

Pleasure/fulfillment

Oral sex

Anal sex

Sex toys & accessories

Sexual fantasy

Sexual trauma

Any other topic you wish to address

Thank you! Now please fill out the coaching agreement form.