Sessions Intake
birchandlavender.com
Name
First Name
Last Name
Referral Source:
Email
example@example.com
Phone Number
Please enter a valid phone number.
Date of Birth:
I acknowledge and honor the lineages you carry. Are there any aspects of your ancestry that you would like to share with me?
Our intentions and goals will guide this work together. I am here to support your deepest aspirations for yourself. Please take a moment to reflect on and state your intentions regarding sexuality, eros, spirituality, and well-being.
Are there specific topics or areas you want to explore during our sessions?
What do you remember about your sex education growing up? How did your family of origin discuss the body and sexuality?
While many have shared that this work is healing, it's important to note that it is not therapy. With that in mind, what makes you feel most resourced in life? What support systems do you have in place, to lean on, during challenging times?
Please share any challenging experiences from your sexual or sensual history that you feel comfortable discussing.
Please share any positive experiences from your sexual or sensual history that you would like to highlight.
What would you like to share about your current intimate relationships?
If you have a partner(s), are they aware that you will be engaging in Somatic Sex Education work? Would you be interested in having them join you for some of the sessions?
Please share any previous experiences you have had with sex therapy and/or sexual bodywork (such as sexological bodywork, sensual massage, sex work, surrogate partnerships, tantra, etc.). If you are currently working with a therapist, are they aware of your interest in Somatic Sex Education?
How does your body respond when you are feeling unsafe or overwhelmed?
How does your body respond when you are feeling safe and supported?
What are your feelings about your body? In what ways do you nurture your well-being, and how do you care for your erotic self?
What would you like me to know about your sexual history or current desire patterns? This may include aspects such as gender identity, sexual orientation(s), self-pleasuring practices, fantasies, use of pornography, or any other information you feel is important to share.
Please share any experiences you’ve had with sexual assault or trauma that you feel may impact our work together. If you would prefer to discuss this over the phone or in person, please indicate that here.
How would you like to feel by the end of our time working together?
What questions do you have for me? Is there anything you would like to know about my experience, background, or anything else that may impact our work together?
Type a question
I understand that any touch will be given only at my request and solely for my own benefit, education, and pleasure.
I understand this work can inspire all kinds of feelings and thoughts, all of which are welcome during a session. I know that Brigid is not a therapist and I will seek appropriate care from a qualified professional, if I need it.
I understand that Brigid does not act as a surrogate partner. She remains fully clothed during sessions. She uses her hands only to educate her clients and never becomes romantically or sexually involved with a client.
I understand that appropriate hygienic protocols will be used, including gloves for all genital/anal touch.
I understand that drugs and alcohol are not compatible with this work.
I understand that payment for each appointment is due before the start of the session. If I cancel an appointment with less than 24hr notice, I agree to pay the regular fee.
I am over 19 years old.
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