Tantra Intake Form

  • Tantra Intake Form

  • Section 1: Welcome & Personal Information

  • Welcome.

    This intake helps determine whether we are a strong fit to work together and clarifies your intentions, history, and readiness to engage in private sessions.

    Please answer honestly and directly, as if writing in your journal or speaking to someone you know well and trust. There are no right or wrong answers, only what is true for you right now. The more direct and honest you are, the more useful our time together can be.

    All information is held confidentially.

  • What are you seeking at this time?*
  • Date*
     / /
  • Format: (000) 000-0000.
  • Preferred method of communication outside of session
  • Date of Birth*
     / /

  • Section 2: Identity and Work

  • Sex assigned at birth

  • Section 3: Relational & Emotional Landscape

    These questions help me understand how you relate, respond, and move within intimacy and connection.
  • Are you currently in a committed or primary relationship?*
  • Does your partner know you are contacting me?*
  • If applicable, is your partner open to or aware of your interest in Tantra?

  • Section 4: Intention & Timing

  • Section 5: Physical & Sexual Health

  • Have you had any injuries, surgeries, or physical limitations that may affect movement, touch, or sexual activity?*
  • Do you have any current contagious illness or health conditions I should be aware of?*
  • Do you have any current or past sexually transmitted infections that are relevant to disclose?*
  • Have you been vaccinated for COVID 19?
  • Boosted?
  • Approximate date of last vaccination or booster
     - -
  • Do you have a history of substance use or addiction that is active or relevant at this time?*
  • Do you have environmental allergies or sensitivities (animals, pollen, scents, etc.) that I should be aware of?*

  • Section 6: Erotic & Sexual Experience

    These questions help me understand your erotic and sexual experience so I can guide you skillfully and responsibly.

  • Which types of orgasmic experiences have you had?
    Check all that apply. You may include solo and partnered experiences.

  • Section 7: Tantra & Practice Orientation

    This section helps me understand your familiarity with Tantra and contemplative practices.
  • Have you experienced Tantric Sacred Spot work or other forms of internal erotic bodywork (such as G-spot or prostate work)?

  • Section 8: Life Inventory

    Please rate how these areas of your life feel right now. 1 = Under strain 5 = Strong and steady

  • Section 9: Readiness & Intentions

  • Private sessions are extended, focused time within a well-defined container where you can meet yourself as deeply as you’re ready.

    On a scale of 1–10, how ready do you feel to commit to focused, honest sessions at this time?

    1 = unsure or hesitant
    10 = fully ready and prepared to commit

  • Section 10: Availability & Scheduling

  • What times of day are generally available for sessions?

  • Section 11: Immersion Inquiry

    Immersion is extended, private work built for continuity and depth. Spending dedicated time together allows momentum to build and insight to integrate in ways single sessions cannot support. Rather than working in isolation, immersion creates a cohesive arc. This format is best suited for those who value sustained focus and deeper continuity.
  • What length of immersion are you considering?

  • Thank you for your thoughtful responses. I appreciate your openness and the care you’ve taken in completing this form. Once I’ve reviewed your intake, I’ll be in touch about next steps.

    Sincerely,

    Ann Vajradakini

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