New Client Questionnaire

Name* This field is required.

First Name

Last Name

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

Phone Number

Area Code

Phone Number

Reasons I want to try a cuddle session

Better sleep

Trauma recovery

Soothe anxiety

Improved health

Human contact

Because cuddles.

Emotional support

ALL OF THE ABOVE!

How did you hear about Professional Cuddles?

Google search

Facebook

Instagram

Business Card or Flyer

Met coach in person

Referral

Other

Have you experienced a professional cuddle session before?

No, this is new for me

Yes, I'm an experienced cuddle veteran!

I think platonic touch therapy (cuddling) is:

Awesome, I love it!

Interesting...

Kinda weird

Please don't touch me

What is your attachment style?

Anxious Preoccupied

Securely Attached

Dismissive Avoidant

Fearful Avoidant/Disorganized

I don't know

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

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

PTSD (Post Traumatic Stress Disorder)

CPTSD (complex/childhood PTSD)

Addiction

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

Neurodivergent

Highly sensitive

Immunocompromised

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

If you have experience with other therapies, please share a little about what you have explored so far:

Tell me how you really feel about:Collecting vital data...

We have a new therapy animal program at Professional Cuddles. Do you have any interest in sessions with our puppy assistant?

Yes

Maybe

Unsure

Indifferent

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!

Got anything else you would like to ask or share?

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!