Intake Form Art of Eros
Sign in to Google to save your progress. Learn more
Email *
Your name *
Any preferances/ triggers I should be aware of to best work with you? If you have worked with a professional before: what were the approaches you liked and disliked? *
What is your intention for working together? How will these sessions support your personal growth? *
Do you currently have any bodily or mental conditions/ injuries I should be aware of?
 *
Have you suffered any adverse childhood experiences? E.g. loss of a parent or sibling/close family member, conflict, difficult divorce situation,  sexual, mental or emotional abuse, violence, bullying, disease, ... If yes, please explain:
 *
If I experience any pain or discomfort during this session, I will immediately inform the practitioner.
 *
Sessions do not include a "happy ending" / peak orgasm.  *
Is there anything else you would like me to know?
 *
To prepare for the session as best as possible, I invite you to journal beforehand on the topic you want to work on. Get clear on a concrete intention if you haven't yet.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms