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Private Client Questionnaire

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Before We Begin. This private intake is your first step into a space that values discernment, depth, and devotion. There are no right answers—only honest ones. Take a few quiet moments to respond in a way that feels true.

Your responses are seen only by me, and they help reveal whether this experience is meant for us to share.

Private Client Questionnaire

Leave a Comment

Full Name

Email *

1. What best describes your current experience with intimacy? *

I feel disconnected and unsure how to fix it

I’ve had fulfilling experiences but want deeper connection

I’m very experienced but something is missing

I’m very experienced but something is missing

2. Which of these outcomes would feel like success for you? *

More confidence and skill with partners

Feeling sexually alive and powerful again

Healing emotional blocks around intimacy

All of the above

3. What best describes your level of commitment to this work? *

I’m just browsing or curious

I’m interested, but I’m not ready to invest yet

I’m ready to invest time, energy, and money to transform this part of my life

I’ve been looking for someone like you and I’m ready to begin

4. Which of the following most closely reflects what you’re willing to invest in your growth in this area? *

I’m hoping for free or low-cost support only

I could manage up to $200/month

I’m ready for coaching in the $500–$2,000/month range

I’m ready to invest $3,000+ in deep, private work

5. What have you spent money on in the past to improve your personal life, dating, or intimacy? (Select all that apply) *

Therapy

Dating coaches or relationship courses

Tantra, somatic work, or retreats

None yet—but I know I need to

6. What made you curious about working with me? *

7. What patterns or struggles are you done tolerating? *

8. If our work together were a huge success, how would your intimate life look and feel in 6 months? *

9. Is there anything I should know about you before we speak? *

START SURVEY

Home
About
Services
Contact

Private Client Questionnaire

Leave a Comment

Before We Begin. This private intake is your first step into a space that values discernment, depth, and devotion. There are no right answers—only honest ones. Take a few quiet moments to respond in a way that feels true.

Your responses are seen only by me, and they help reveal whether this experience is meant for us to share.

Private Client Questionnaire

Leave a Comment

Full Name

Email *

1. What best describes your current experience with intimacy? *

I feel disconnected and unsure how to fix it

I’ve had fulfilling experiences but want deeper connection

I’m very experienced but something is missing

I’m very experienced but something is missing

2. Which of these outcomes would feel like success for you? *

More confidence and skill with partners

Feeling sexually alive and powerful again

Healing emotional blocks around intimacy

All of the above

3. What best describes your level of commitment to this work? *

I’m just browsing or curious

I’m interested, but I’m not ready to invest yet

I’m ready to invest time, energy, and money to transform this part of my life

I’ve been looking for someone like you and I’m ready to begin

4. Which of the following most closely reflects what you’re willing to invest in your growth in this area? *

I’m hoping for free or low-cost support only

I could manage up to $200/month

I’m ready for coaching in the $500–$2,000/month range

I’m ready to invest $3,000+ in deep, private work

5. What have you spent money on in the past to improve your personal life, dating, or intimacy? (Select all that apply) *

Therapy

Dating coaches or relationship courses

Tantra, somatic work, or retreats

None yet—but I know I need to

6. What made you curious about working with me? *

7. What patterns or struggles are you done tolerating? *

8. If our work together were a huge success, how would your intimate life look and feel in 6 months? *

9. Is there anything I should know about you before we speak? *

START SURVEY

Our location

Discreetly based in Northern California. Serving a select global clientele through private, one-on-one sessions.

Availability

By appointment only (Completion of private intake required before booking)

Contact

Email: [email protected]

Our location

Discreetly based in Northern California. Serving a select global clientele through private, one-on-one sessions.

Availability

By appointment only (Completion of private intake required before booking)

Contact

Email: [email protected]

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