New Client Questionnaire

1

Name* This field is required.

First Name

Last Name

2

E-mail* This field is required.We will need this to get ahold of you!

3

Phone Number

Area Code

Phone Number

6

Have you experienced a professional cuddle session before?

No, this is new for me

Yes, I'm an experienced cuddle veteran!

7

I think platonic touch therapy (cuddling) is:

Awesome, I love it!

Interesting...

Kinda weird

Please don't touch me

8

Please help us understand any special needs or conditions you may be experiencing:

Mobility limitations (I need help with stairs/moving, transferring or repositioning)

Immunocompromised

PTSD (Post Traumatic Stress Disorder)

Addiction

In crisis (divorce, job loss, grieving etc.)

9

Please feel free to share any details regarding your needs and how we can best serve you:

11

Before Proceeding:

Please be sure to read through our Client Agreement & Waiver.

You will need to sign this agreement before your first cuddle session, so please make sure you understand our policies before booking anything!

12

Got anything else you would like to ask or share?

13

For more information, please visit us at www.professionalcuddles.com

Thank you so much for filling out our new client questionnaire!

All that's left is to click SUBMIT!