The courage and vulnerability that it takes to create strong healthy relationships is a gift unto itself.  May you feel seen, supported, nourished, and comfortable in all the sharing we do together in this healing journey, which starts now.

I ask that each partner fill out an individual intake form so that I may direct the session to fit each of your needs.  I appreciate your openness and authenticity in the answers you give on this from.  
All information shared here is confidential.

“It’s not about gender or age, nor even social conditioning, religious belief or other external preferences. To surrender as Love is to become vulnerable, fragile, soft, sincere, open hearted, and “wound-able” as a choice to the alternative of living miserably inside walls and masks, hiding from pain and Joy.” 
― Nityananda Das, Divine Union

NOTE: Because you will NOT be able to save your answers once you begin, I suggest that you read through this form once, then pre-write your answers, and then copy/paste them into the form at once.

Name *
Phone *

Thank you for the beauty of your desire to grow, heal, and explore!

"Intimate relationship is perhaps the ashram of the 21st Century—a place especially ripe with transformational possibility, a combination crucible and sanctuary for the deepest sort of healing and awakening, through which the full integration of our physical, mental, emotional, psychological, and spiritual dimensions is more than possible."
~ Robert Augustus Masters

I look forward to our time together. If you have any questions feel free to contact me.