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SOMATIC SEX EDUCATOR

AND SEXOLOGICAL BODYWORKER

Pleasure is Healing

Intake Form

Thank you for your interest in exploring the potential benefits of attending somatic sex education sessions. You are invited to complete this confidential intake form and share information with me about your sex and intimacy history and goals. What does sexual wholeness mean to you?

Please click onto the Intake Form link below. Fill out the form and Submit It to me electronically.

Intake Form

Confidentiality Agreement

This completed form, along with all or correspondence with you, is kept strictly confidential. I sometimes share segments of client or session information with my peer colleagues or field mentors for professional consultation and supervision purposes, but identifying names are removed to maintain client privacy. There are situations when the confidentiality agreement can be set aside; if a client poses a danger to themselves or others or if a child is at risk of being harmed or is in need of protection.

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