Bespoke Retreat Intake Form: Learn the Fundamentals of Totality Tantra Therapy

Intimacy Coaching and Totality Tantra Therapy for Individuals and Couples

Your First and Last Name

Your Phone Number

Your Email Address

Your Gender (optional)

Pronouns (optional)

She/her

He/him

They/them

She/them

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Not listed

Your Age (optional)

How did you find me? (optional)

What length of in person retreat are you interested in?

2 days

3 days

Other

Please give more details about your ideal length:

Share with me your thoughts, ideas and inspirations about what you might like to learn during this bespoke retreat. What would you like us to focus on? You don't need to know concretely or fully but give me as much detail as you can about the ideas you do have.

What has inspired you to want to have a bespoke retreat and to focus on the areas you mentioned above?

What has inspired you to want to work with me specifically? (optional)

What are some intentions/outcomes you hope to achieve personally (or even professionally) beyond just learning new things by having a bespoke retreat? (optional)

Is there anything else you’d like to share about yourself, where you currently are in your life, significant things about your erotic journey, etc to help me get to know you better?

Do you have any questions for me?

I usually offer retreats on Saturdays and Sundays, though other days may be possible. Please share with me your upcoming availability and when you might like for this retreat to be. (optional)

Feel free to schedule a discovery call/AMA session with me so we can answer all your questions and make sure we craft the ideal experience for you. Use this link here: (optional)

https://calendly.com/clairerumore/20-minute-clarity-call

If you're unable to find a time in my Calendly for a discovery call, please send me an email at hello@clairerumore.com so we can find other dates/times that can work.

Thank you