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First & last name

Partner's first & last name (if in relationship)

Email

Phone (We promise we won't call you without permission)

You are welcome to tick multiple boxes to the questions questions below.

WHAT'S YOUR CURRENT RELATIONSHIP STATUS?

WHAT'S MOST PRESENT IN YOUR RELATIONSHIP RIGHT NOW?

We feel emotionally disconnected

Our physical intimacy needs a reboot

We struggle to communicate vulnerably

Things are good, but we want to go deeper

We’re on totally different pages right now

WHAT WOULD YOU LOVE MORE OF IN YOUR RELATIONSHIP?

ARE YOU OPEN TO SUPPORT IN THIS?

We're unsure. Maybe.

We're most likely to 'dip our toes' with a one-off therapeutic coaching session

Your 8-week Awakened Intimacy bootcamp sounds interesting

A Couples retreat feels dreamy!

No thanks, we're just watching for now.

ANYTHING ELSE YOU WANT TO SHARE?

Intimacy