Kindred Tantra - D/s & DDlg Intake

Kindred Tantra - D/s & DDlg Intake
All information is private and confidential and will never be shared. Please be as open and honest as possible.
Email address
example@example.com
Full Name - Including Surname
Your preferred pronouns?
Contact Phone Number
Age (I only work with those 18 years of age and over)
Which Dynamic are you wishing to explore?

Do you suffer from any medical conditions that I should be aware of; such as (but not limited to) heart conditions, breathing difficulties, skin conditions, epilepsy, diabetes or any other conditions?
Do you have any Sexually Transmitted Diseases or any other potentially contagious infection/disease?
Do you suffer from any psychological conditions I should be aware of?
Are you currently receiving any treatment(s) that will conflict with our dynamic? If in doubt I always recommend checking with your Health Care Provider. If yes then please provide details.
Do you suffer from any allergies? If yes then please provide details.
Are you pregnant?
Are you currently taking any medication prescribed or otherwise that I should be aware of? Does this medication have side effects which affect you in your every day life?
Have you ever experienced Physical, Emotional, Psychological or Sexual abuse? If yes please provide as many details as you feel comfortable sharing; this information is important for me to know so I can customise the session to your needs.
Do you have any triggers that you are aware of?
Is there any other information regarding your health that you feel I should be aware of?

By submitting this intake form, you are entering into a collaborative agreement with Kindred Tantra for your one-month Somatic Dynamics container. Please review and confirm the following: 1. Informed Consent & Autonomy: I understand that while I am entering a power-exchange dynamic (D/s or DDlg), I retain my full autonomy. I give my informed consent to explore the themes, kinks, and sexual contact selected in this form. I understand that I can withdraw or shift my consent at any moment, and my boundaries remain the absolute priority. 2. Personal Responsibility: I acknowledge that this work involves deep emotional, physical, and psychological exploration. I engage in this service at my own risk and confirm that I have disclosed all relevant medical or psychological conditions that may impact my safety. 3. Privacy & Data Handling: I grant permission for my personal details to be held securely and confidentially by Kindred Tantra. This data will be used solely to facilitate my monthly contract and to support the development of Kindred Tantra’s somatic and shadow-work methodologies. 4. Anonymised Case Studies: I understand that anonymised data (where all identifying features are removed) may be used for educational purposes or marketing case studies to help others understand this work. Note: If you wish to opt-out of anonymised data use, please check the box below or discuss this with me directly. 5. Terms & Aftercare: I have read and understood the full Terms and Conditions, including the aftercare recommendations provided at www.kindredtantra.co.uk.
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