Pleasure Alchemy - Intake Form

Pleasure Alchemy 𓆩♡𓆪 Intake Form

Welcome! I'm so excited that you'll be a part of this journey. Please fill out the intake form below to help me learn how I can best support you. Invitation to share whatever feels comfortable and know that this form is confidential.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How did you hear about Pleasure Alchemy?
What would you be most excited to get out of this program? invitation to share what you're comfortable about your vision for your relationship with body, sexuality and connection.
What is your experience with Somatic Sex Education, Tantra, embodiment work or anything else that may be relevant.
Is there anything else that you would like me to know about you?
What method of payment do you want to use?

Early Bird

Until October 5th

$650.00 CAD Quantity

Regular Price

$700.00 CAD Quantity

Enter coupon

Total

Pleasure Alchemy 𓆩♡𓆪 Intake Form