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Conscious Sensuality Intake Form

Previous and current illnesses or medical conditions including STD’s and psychological

These sessions, courses, and training are designed to provide an opportunity for you to experience conscious sensuality that can have profound results for your life.  The techniques and methods have helped many people to have a greater awareness of their bodies, relationships, emotions, sexuality, communication, and spirituality.  Your focus may be: on healing specific issues, on greater awareness, empowerment, and communication, on releasing trauma or expanding your capacity for pleasure and vital energy.  This can be a profound, life-changing experience.


Fill out this intake form as honestly and completely as possible as this will help you to connect with yourself and assist us in guiding and supporting you.   To prepare for your sessions or course, please read the Before/After Session Guide and FAQ sheet and ask us any questions.  


It is up to you to get the most out of this experience so let us know what your goals, intentions, and boundaries are.  


Typical in-person sessions include:

  • Intake form review (initial session)

  • Conscious communication and emotional release modalities

  • Coaching including: the identification of goals/intentions, communication for connection rituals, and regular practices for healing. growth, expansion, and pleasure

  • Resolution phase with referrals, scheduling, and homework

Intake Form for Coaching, Training, & Mentoring

Purple Epoxy


Working with sexuality is powerful and potentially harmful without clear understanding and agreement about the work.  Many people have found great healing, empowerment, clarity and freedom in Conscious Sensuality.  At the same time, some people may have experiences that are less than optimal or even leave people feeling used and abused.  No one coach or therapist knows all the answers or is right for every client.  We focus on going slow, breathing, feeling and verbally communicating.  We are grounded in meditation, interoception, introspection and not on magical thinking.  We are trauma-informed and continue to upgrade and make changes to create more safety and accountability.  If you have questions or concerns you can always give feedback, make requests and set up a mediated discussion.  If you want to do so anonymously, you can ask a friend or neutral 3rd party mediator/facilitator to hold a dialogue with us.  Please know we support your healing, growth and empowerment and want to hear your truth.  For several years, Robert took a break from teaching and working with clients to do inner healing and complex trauma work.  If we don't feel we are a good match for you we will recommend another coach, teacher, therapist or school to support you.

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