• sex & somatics

  • Thank you for your interest in working with me.

    I agree to work with clients based on my ability to meet their individual needs and our compatibility to work together.

    Please answer all questions to the best of your ability. I respect your privacy - all information you provide below is completely confidential and will not be shared with anyone.

    If your application is accepted, I will contact you via email within 3-5 days to schedule a 20-minute consultation call ($30) over the phone so I can give you a better idea of what you can expect from our sessions, answer any questions you may have for me, and let you know what the next steps are for moving forward.

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  • Date of birth*
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  • What types of sessions are you interested in? Select all that may apply*
  • Do you have access to the internet?*
  • What is your gender?*

  • What are your sexual orientations/identities?*

  • What is your current relationship status/orientation? (Select all that apply)*

  • What religious//spiritual//philosophical beliefs do practice//align with?*

  • Are you currently working or employed?*

  • How many hours per week do you work?*
  • What issues are you currently dealing with or have you dealt with in the past? (Select all that apply)*
  • Are you currently working with a therapist, counselor, social worker, or other licensed mental health professional?*
  • Have you ever worked with a therapist, counselor, social worker, or other licensed mental health professional?*
  • What areas would you like to focus on? (Select all that apply)*
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