Cancer, Sex, & Women Group Application

Thank you for your interest in working with me! 


I honor your courage and willingness to improve your life, and ultimately your well-being, through deepening your sense of body wisdom, desire, and pleasure. 

These are my areas of expertise.


I will help you to listen, know and love your body so that you may increase intimacy with yourself, which is primary, and have an unshakeable sense of your self-worth. In turn, these foundational elements will serve you to have a better understanding of your sexuality and create healthier relationships.


Some of the many benefits of my coaching work include (but are not limited to):


  • Discovering the wisdom of your body

  • Learning how to trust and claim your desires and your arousal

  • Transforming any latent body or sexual shame into body wisdom

  • Becoming present in, proud of, and connected to your body- regardless of shape or size

  • Developing real relationships stemming from honesty

  • Learning where desire lives in your body

  • Becoming increasingly willing to have what you want, including more pleasure

  • Living your life as a sensual adventure and becoming a better lover


This form helps us prepare for our work together.  It gives me clarity about the support that you are seeking and what your goals are. It also gives you an opportunity to identify what you want and to begin to clearly articulate that, not only to yourself, but to me. This is a powerful place to begin.


Take your time answering the questions. Please answer them to the best of your ability, so that I may both know you better and best serve you.


Your responses are confidential.


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Email *
Your Legal Name: *
 *
The name you prefer:
Your phone number:
What challenges, fears, or concerns are most pressing in your life right now? What are you seeking support with?
What have you done to try to resolve these challenges?
How did that work for you?
What impact is not resolving these challenges having in your life?
How much longer are you willing to deal with these challenges?
What would you like instead? What are your primary goals or desires?
Describe what your life would look like if you achieved your goals and desires.
On a scale of 1-10, how committed are you to getting the results you want?                                                 Not very committed, 1 to Committed and ready to begin, 10
Are you willing to invest in yourself your personal treasures of time, money, and attention in order to create the change and resolution you want?
What days and times are best for you to attend this group? Please include three potential days, times, and your time zone.
Specifics about the Cancer, Sex, and Women Group  
This is a powerful, transformation group limited to six women. You may submit an application to be considered for the group. Groups will be formed when we have a selected a successful cohort based on the completed applications. Please submit yours to be considered.

Payment is $90 per weekly group and due monthly at the last day of the previous month. For example, payments for October are due September 30th. Payments are based on the number of groups in a month. If group is on Wednesday and a month has four Wednesdays the cost is $360; if it has five the cost is $450 due the first of each month. If you are not in attendance, you are still responsible for payment to hold your space in the group. 

If you need to leave the group, you may cancel your membership the month before you plan on leaving. This is important as endings can be difficult. The group will need to know in advance, so that closure may be facilitated properly for both the individual leaving the group and the group.

“Thank you for your submission. If you have any questions or would like to set up a time to speak to assess if this group is appropriate for you, please email me at Tara@TheGaleanoGroup.com. I look forward to hearing from you.”
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