coaching Interest application

I am excited to share this work with you!

Please tell me more about yourself and your expectations.

Name

First Name

Last Name

Mobile Phone

(###)

###

####

I consent to receiving text message communication regarding this application.

*We respect your privacy and promise to only communicate via text regarding your application unless otherwise provided consent for further communication.

Yes

What is your occupation?

I am interested in:

Intimate Artistry Coaching

Relationship Transformation

What are three things you most want from our work together?

What are three things that you want to move through, release or transform in our time together?

Are you currently in a relationship?

Yes

Can you share a few sentence or paragraphs regarding your sexual history that feels relevant to our work together?

Can you share a few sentences or paragraphs regarding your relationship that feels relevant to our work together?

What are you afraid of about working together?

What can I do that will make you feel safe & supported in our work together?

What are you struggling with in life right now?

Is there anything else you would like me to know?

Please tell me the name of your partner (if applicable) in this space.

I understand I will be required to sign a Liability Release, Coaching Contract & Payment Contract before coaching sessions begin.

Yes, I agree

I understand I am responsible for the outcome (s) of my coaching. I am fully responsible for my growth, dedication, and commitment to being coached.

Yes, I agree