Mama Comes First 1:1 Coaching
This form is a first step toward working together. Your answers help me understand where you’re at, what you’re needing, and how I can best support you. Nothing here has to be perfect — just honest. Once your submission is receive you will receive a follow up email within 24 hours with next steps.
Name
*
First Name
Last Name
Pronouns
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What made you interested in 1:1 coaching?
*
Are you interested in...
*
A single session (one-time deep dive)
Ongoing coaching (weekly or biweekly)
Not sure yet — I’d like to talk about what’s best for me
What Time Zone Are You In?
Preferred days/times for sessions (check all that apply):
Preferred days/times for sessions (check all that apply):
Weekday mornings
Weekday afternoons
Weekday evenings
Weekends
My schedule is unpredictable — let’s talk about it
What are you hoping to work on or explore in our sessions?
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Libido/desire
Body image or body reconnection
Navigating sex in pregnancy
Navigating sex after baby
Touch aversion or feeling “touched out”
Pleasure exploration
Shame or discomfort around sex
Partner resentment/mental load impact
Perimenopause
Sex Education
Menstrual Cycle Education
Cycle Syncing
PMDD Coaching
Which stage of motherhood best describes you right now?
*
Pregnant
Postpartum (0–12 months)
Postpartum (1+ years)
Parenting young kids
Parenting older kids or teens
Perimenopausal
Not sure / Other
Have you ever worked with a coach, therapist, or provider around sexual health or intimacy before?
Yes
No
Other
(Optional: If yes, feel free to share what that was like or why you’re seeking something different.)
How do you want to feel by the end of our work together?(Open text – give them space to dream a little)
*
Anything else you’d like me to know?
Submit
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