Request a Session
Submit this form to receive a response regarding Tantra-Informed Mediation™ or Mediation Preparation within two (2) business days.
Name
*
Name
Pronouns
E-mail Address
*
example@example.com
Alternate Contact Information
Type of Session
First Mediation Preparation
Continued Mediation Preparation
First Tantra-Informed™ Mediation
Continued Tantra-Informed™ Mediation
Provide a brief description of the dispute or the issue(s) to be discussed.
List the necessary participants, their role in the dispute or issue(s), and their contact information.
Request a Date and Time
*
Would you prefer for the session to be conducted virtually or in-person?
Please Select
Virtually (via Zoom)
In-Person (location TBD)
Hybrid
Submit Request
Should be Empty: