Welcome to Closeness Coaching. If you’re looking for sexual guidance, intimacy or relationship support, or life coaching, you’ve come to the right place. I know it took a lot for you to get this far, so know that I will take very good care of you from here on out.
Below is an optional intake form. None of the questions are mandatory, but clients often find that filling it out helped them clarify their thinking and solidify what kind of help they want.
If you don’t know an answer, please take a moment to reflect on it before moving on. If you don’t feel comfortable answering, simply leave it blank. To move to the next field press tab on a computer or tap the down arrow or next field on your mobile device.
Your answers are confidential, and this form is never shared with your partner electronically or on paper. However, given the nature of the help you are seeking, it is likely we will discuss some of these subjects in person. If there are any topics or answers that are off limits, or you prefer to keep between us, you can share this in the consent section found on the last page of the form.
When applicable, please have both partners fill out this form individually.
Congratulations! You just got the hardest part done. Siting down with me is next, and I’m very competent at making this whole experience feel comfortable and safe for everyone involved. I’m looking forward to meeting you soon.