Questionnaire

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PERSONAL PROFILE

Before I see a client, I request a personal profile so that I can customize your session to best meet your needs and goals. Please fill out the form with as much information as you would like to share. Everything that you share with me is confidential. The more authentically you communicate your needs and interests, the better I will be able to assist you.

Sessions may include meditative breath-work, toning and energy movement, eye gazing, honoring, sacred-spot, awakening-the-senses using exotic and essential oils.. You will feel cared for and nurtured. You will walk away feeling energized and renewed; taking with you skills that you can practice by yourself or with a partner.

So many of us are shut down or shut off from really feeling. These "blocks" keep us from experiencing our potential for the prolonged pleasure, intimacy and deep connection that we all long for. By consciously working with our energy system, we have the opportunity to break through the blocks that hold us back from ecstatic love.

I thank you for inviting me on your journey!

Name*

Email Address*

Birth Year*

Are there any reoccurring challenges that you would like to address during your session?

Physical/Sexual Health:

Do you have any health issues or have you had in the past?

Is there a sexual or emotional abuse history in your childhood or family? If so please give a brief description.

Are you presently in a relationship?

If you are in a relationship are you happy with your feelings of connectedness, intimacy levels and/or sexual relations?

If you are in a relationship, is your partner open to Tantra?

Briefly describe your relationship with your family.

Have you ever experienced a full body orgasm?

Have you ever had an orgasm without ejaculating?

As an intention, what would you like to have more of in your life?

As an intention, what would you like to release from your life?

What is your desired outcome from our meeting?

Have you seen a Tantra practitioner or Psych-K Pro in the past? If so, how was your experience?

Is there anything that I did not ask that you would like to share or add?

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Thank you for sharing yourself with me . I look forward to being a part of your journey!

Many Blessings........Please:

Arrive on time

Open to your journey

Freshly showered

12 - Hour cancellation policy ( deposit required on first visit, next day)

Please no alcohol or drugs, as it will detract from your total experience.

There is no sexual contact with me, this is all about you!

Love and Light,

Tara

Tara Lotus Temple

BODY, MIND, SPIRIT TRANSFORMATION CENTER