Sacred Eros ~ iNiTiAL iNTEREST Assessment ~ Reservation Request form 🌹🖤
Thank you for expressing interest in working together!  

This form is intended to help me better understand your current state, your goals, and how I may bring value to your life.  

Submission of this form does not guarantee a reservation. Submission of this form indicates a REQUEST to work together.

You will receive *CLEAR CONFIRMATION* directly from me *IF/when your reservation request is accepted.
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Email *
How would you like to be addressed? This might be your given name or a role play name you've always wanted to try ;) *
Would you prefer to correspond over phone via text message? If yes, provide a secure number. If no, type N/A or leave blank.
Please share with me a brief bio (age, occupation, lifestyle, etc). *
Which city are you located in? *
Have you received shamanic healing, tantric work or intimacy coaching before? If yes, please elaborate. *
In a few words, why do you want to work with me? What about my profile resonates with you? *
What outcomes are you seeking from our session? *
Do you have any injuries or medical conditions I should know about? (high blood pressure, anxiety, diabetes, rash, allergies, etc). *
Which service(s) are you seeking? Select all that interest you. *
Required
Offer at least 3 dates and times you are available to meet for session.  *
Our time together is Sacred, I honor yours and you honor mine. With that in mind, I require new clients to secure their RSVP with a $250 (non-refundable) deposit.

How will you be sending the deposit?

(Note: I will *only* share my deposit address if/when I   *accept and confirm* your request for appt. I will never accept money from you unless I am fully committed to holding our session)
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What is something that made you smile today?
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