Couples Immersion Application

First Name

Last Name

Age

Gender/Identifying Gender

Where do you currently reside? (Country, State & City)

Phone Number (Area code, plus country code if outside the US)

What is your preferred time of day for calls/texts?

Morning

Afternoon

Evening

Can you share a little bit more about your profession?

What are your deepest hopes and intentions for this sacred experience together? What do you most wish to open, heal, or awaken as a couple?

Are you wanting to do in person sessions, online or a combination of both?

In-person

Online

Combination

I'd be willing and able to come to Kauai for a VIP immersion day if invited

How do you prefer to work with me?

What led you to seek me out? Is there something you're currently challenged with? How long have you been dealing with/struggling with this? How has this impacted your life?

On a scale from 1-10, how committed are you to transformation and growth?

Do you have a personal practice for connecting to your own life force energy, body, or inner world? (breathwork, movement, meditation, etc.)

Where in your relationship do you feel the most aliveness, flow, and energetic connection?

Where in your partnership do you feel a sense of longing, disconnection, or unexpressed energy?

Is there a way you wish your partner showed up for you energetically, emotionally, or spiritually that feels missing?

How often do you share moments of true presence and heart connection with each other?

How do you feel after moments of deep energetic or emotional release? (loved, depleted, expanded, grounded, etc.)

What do you most love about moments of deep union, vulnerability, and energetic merging with your partner?

If I feel you would benefit from working with me and I sense you are ready and aligned, ideally when would you like to have your first session? What days and times generally work best for you?

As my sessions are very intimate, discretion and safety is paramount. Are you able to provide a business website, LinkedIn profile or other social media profile so I may verify who you are? Please add URLs below.

Do you have any physical limitations, challenges or health concerns I should know about?

Are you comfortable being naked?

Working with me is an investment in yourself. I have packages ranging from 4 figures all the way to 7 figures. Are you ready to go all in?

Yes

Is there anything else you would like me to know?

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