Somatic Sex Education - Long Intake

Somatic Sex Education can include coaching in breath, movement, body awareness, boundary-setting, communication, anatomy, sensate focus, massage, and other body-based teaching about sex. Somatic Sex Education is designed to nurture, deepen or awaken the sensual self. Whether you want to heal feelings of sexual shame, explore the intersection of sex and spirit, better express your desires, or deepen erotic pleasure, I welcome you on this journey.

 

Please complete the form below 

Name *
Name
Phone *
Phone
Date of Birth
Date of Birth
Sexual History and Information:
(Please address only those questions that feel relevant. I assure professional confidentiality. If you want me to work together with your psychotherapist, medical doctor or other health practitioner, I will ask you to sign a release form.)
Bodywork: Somatic Sex Educators who are Sexological Bodyworkers are trained to do genital and anal touch, at the request of the student, and when deemed appropriate by the practitioner. Through this touch, we assist students in developing presence within the body, opening interior awareness, and learning how the body can become more and more alive. We offer experiential learning opportunities that consciously access profound ecstatic and erotic states. If you would like to include bodywork as part of your learning experience, please complete this section of the intake form:
Do you have any of the following conditions?
Are you taking any medication or substances that could block pain or relax your muscles?
INFORMED CONSENT AND WAIVER
Please read carefully. By checking each box, you are acknowledging and agreeing to these terms.
Somatic Sex Education is not psychotherapy or medical treatment.
I understand that any touch will be given only at my request and solely for my own benefit, education and pleasure. I agree to communicate my needs as they arise, including stopping any exercise at any moment, should it become uncomfortable for me.
I have stated all medical conditions that I am aware of, and I will update Monica on any changes in my health status.
Monica does not act as a surrogate partner. She remains clothed during sessions. She will not become romantically or sexually involved with a client. I understand that these sessions are about me, my own internal experience, and intended to deepen my relationship with myself.
All touch involved is one-way only, from practitioner to client. Any deliberate violation of this protocol will result in termination of the session without refund.
Appropriate hygiene protocols will be used, including gloves for all genital touch.
Drugs and alcohol are not compatible with somatic sex education. Any client arriving to a session under the influence of drugs or alcohol will be sent home.
In certain cases the complexity of client concerns may be outside the scope of Somatic Sex Education. While the initial intake process helps determine this, sometimes it can only be fully determined after a few sessions. I understand that Monica may recommend other modalities (such as psychotherapy) alongside OR instead of Somatic Sex Education. Monica reserves the right to terminate sessions with those clients whose needs are outside of her scope of practice.
Cancellation Policy: 24 hours notice for cancellations is required. For prepaid sessions, failure to show up for the session or less than 24-hours notice of cancellation will result in loss of that session. Emergencies are exceptions.
By signing this release, I hereby waive Monica and The Inner Arts Collective of any and all liability, past, present or future, relating to Somatic Sex Education and Bodywork.