Book a Session With Me! Name * First Name Last Name Name you prefer to be called Email * Phone * (###) ### #### How old are you? * 18-29 29-45 45-60 60+ Have you ever worked with a coach before? * Yes No Please breifly describe your gender, sexual orientation and relationship orientation. (If you're not comfortable answering this question just put N/A) * Please briefly describe what you're looking for in a coach and why you're interested in working with me. * Do you participate in BDSM? * Yes (Lifestyle/Community) Just in the bedroom Im new/curious/exploring No Are you currently seeing a therapist? Coaching is not therapy, but it can be theraputic when used alongside therapy. It is strongly suggested that you have a therapist while working with me. If you do not, we will discuss it in our intake call and see if what you need is compatible to my work. Yes No How do you prefer to be contacted? * Phone Email Text Thank you! I will be in contact with you soon, please allow 24-48 hours for response Monday-Friday. I look forward to working with you!