Somatic Intimacy Coaching Intake Form

Somatic Intimacy Coaching Intake Form

A Desire-Led Discovery
Name

First NameLast Name
Email
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Phone Number
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✨ Before our call, take a few moments to gently reflect and respond to the questions below. These prompts are here to help me understand what’s alive for you right now—your desires, your challenges, and the places within you longing to be seen, held, and transformed.
What called you to explore Somatic Intimacy Coaching at this time?✧ You don’t have to know all the answers—just share what feels present.
When was the last time you felt truly connected to your body—or someone else’s?✧ This could be emotional, sensual, or physical.
When was the last time you felt truly connected to your body—or someone else’s?✧ This could be emotional, sensual, or physical.
What feels the most tender, challenging, or stuck in your intimate or relational life right now?✧ You can be as honest or soft as you’d like.
Is there anything from your sexual, relational, or body-based history that feels relevant to our work together?✧ This is a space to share what you’re ready to, without pressure.
What are 2–3 themes or patterns you feel ready to shift, release, or explore more deeply?✧ These could be emotional, energetic, sexual, or relational.
If you could wave a magic wand, what would your intimate life look and feel like?✧ Describe it through sensation, emotion, and experience.
On a scale of 1–5, how ready are you to begin coaching if it feels like a fit?✧ 1 = Just curious | 5 = Fully ready to invest in change

1

2

3

4

5

1 is , 5 is
Is there anything else you’d like me to know before we meet?✧ This is your space—no wrong answers.
Thank you for taking the time to share a piece of your world with me. This isn’t about fixing you—it’s about remembering the truth of who you are.
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