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.
Where are you based?
How did you hear about Pleasure Alchemy?
Are you signing up with anyone? If so, add their name here
What would you like to get out of this program? invitation to share anything you want me to know about your vision for sexuality, embodiment, relationship and pleasure.
What is your experience with Sacred Sexuality, Tantra, Somatic Sex Education, embodiment practices or anything else that may be relevant.
Do you have anything that you would like me to know about working with you?
E-transfer to bodybelovedcoaching@gmail.com (Canadian banks only)Credit Card3 payment plan - For this option please E-transfer 1/3 of your tier price to complete this application and secure your spot. I will follow up with scheduled credit card invoices

My Products (credit card only)

Pleasure Contributor

By choosing this tier, you help make the program more accessible to participants who would otherwise be unable to join. Your contribution directly supports a more diverse and inclusive container.

$780.00CAD Quantity

Pleasure Sustainer

This is the standard cost of the program. It reflects the depth of teaching, facilitation, included materials + resources, and lovingly curated support offered throughout the container.

$650.00CAD Quantity

Pleasure Support - SOLD OUT (contact me directly)

This option is for those who would genuinely benefit from the program, but for whom the regular rate would be a barrier. It’s here to expand diversity of income levels in the program. Before selecting this ask yourself if paying regular price would impact basic needs.

$520.00CAD Quantity

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Total

$0.00CAD

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Program details:

Dates: Sundays March 15 – April 19th
Time: 11am-1pm Pacific Time
Where: In person – Victoria

Have Questions? Book a complementary call Here

or email me at bodybelovedcoaching@gmail.com
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Pleasure Alchemy 𓆩♡𓆪 Intake Form

Credit Card