Tantric Massage Intake Form

Tantric Massage Intake Form
Name:*

First NameLast Name
Age:*
Email:*
example@example.com
Phone Number:*
Please enter a valid phone number.
Is it appropriate for me to text you at this number?*
Have you experienced a Tantric massage before?*
What would your ideal session with me look like? Why are you drawn to work with me?*
Are there any underlying issues you would like to work on? I.e. - learning to last longer, expanding pleasure etc.*
What are your preferred Dates and Times to see me?*
If you are called to explore Tantra in a more full capacity please go to my website to see what else I offer: www.rosiebitts.com/tantra
As a certified Sexologist it is my ethical and professional responsibility to keep your information confidential so please rest assured that any information you share with me is kept completely private.
Should be Empty: