Name
First Name
Last Name
Email
example@example.com
Gender
What are your intentions in working with me? Your intentions might be your goals, hopes, dreams… and this can change as we work together.
Would you like to share about any health problems or challenges in your life?
How is your breathing?
How would you describe your energy levels?
How is your stress level?
How do you have fun in your life?
Do you have a spiritual practice or sense of the sacred that is part of your life? What is the role of sexuality within this (if any)?
Difficult things from my sexual/sensual history I want you to know are:
Wonderful things from my sexual/sensual history I want you to know are:
Difficult things about my current sexuality/sensuality I want you to know are:
Wonderful things about my current sexuality/sensuality I want you to know are:
On a scale of 0-10, how well do you accept your body as it is (0 =no acceptance 5=moderately accepting, 10= I love and accept my body exactly as it is.)
Tell me about your intimate relationships:
Are you currently suffering from any physical or emotional symptoms related to traumatic experience?
Do you have any sexual history, physical or mental illness or other conditions that may affect your response to a conscious touch session?
INFO: As a Somatic Sex Educator (in my final mentorship) I am trained to provide conscious one way touch at the request of the client in supporting your own education, coaching empowered choice and voice and mind/body awareness. This can involve genital touch, if it is a genital mapping or genital dearmouring session. This touch is offered only at the request of the client/student, and when deemed appropriate by myself as a practitioner. I stay within my own boundaries. Conscious touch can assist students/clients in developing presence within the body, opening interior awareness and learning how the body can become more and more alive.
In the State of Alabama I only offer genital mapping/genital dearmouring sessions for Women and only after you have completed the package called “Conscious Woman” and have the foundational learning and skills that allows this to be a safe, gentle, healing process. If conscious asked for touch might be part of your learning experience, please let me know of any health conditions you are aware of: Pregnancy? Osteoporosis? Heart condition? Diabetes? Breathing Problems? Seizures? Etc?
Are you taking any medication that could block pain or relax muscles?
INFO: Informed Consent and agreement. Please Sign by each agreement...
I understand I must be approximately 30 years old or above.
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I understand that any touch will be given only at my request and solely for my own benefit, education and creating new neural pathways and expanding life energy. I agree to guide Lauren’s touch to ensure that that is always beneficial, educational and supportive for me.
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I understand that in the state of Alabama Lauren will not offer genital mapping or genital dearmouring or any educational genital touch to a male.
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I have stated all medical conditions that I am aware of, and I will update Lauren on any changes in my health status.
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Lauren does not act as a surrogate partner. She remains clothed during sessions. She uses gloves during any genital touch. She uses her hands only for educational touch. She will never become romantically or sexually involved with a student, client.
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Appropriate hygienic protocols will be used, including gloves for internal genital touch.
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Drugs and alcohol are not compatible with somatic sex education.
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24 hours notice for cancellation is required. Emergencies are a rare occasion. If for any reason you have to cancel last minute, the deposit will be transferred once to another session. If a second session is missed/cancelled passed the 24 hour before time frame, no refund will be given and no more transfers.
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I understand that half payment is due before we ever begin. This is non refundable but in case of emergency can be transferred once to a reschedule.
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SUBMIT
SUBMIT
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