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Elite Intimacy Client Application

What is your first and last name?

What is your email address?

What is your phone number?

What is your age?

How would you identify your sexual orientation?

What best describes your current relationship status?

Which best describes your relationship goals?

Which types of personal development have you invested in?

Which best describes your career type?

How would you describe where you are in your career?

With 10 being the most stressed, how much stress would you say you have in your life in general?

What areas of your life would you say you are MOST successful in?

What areas of your life would you say you are the LEAST successful in?

What is your reaction when a partner leans in to get more attention from you?

It depends on how she does it

I welcome attention from them and I want to give attention

I think it's nice

I need to be in the right mood

I get weary when someone is too needy

It's fine

On a scale of 1-10, with 10 being the most ideal, how would you rate your childhood

What sexual areas would you like to learn more about?

With 10 being the highest, how would you rate your sexual drive consistently?

How would you say partners have matched you in your sexual drive?

I've always had a higher sexual drive

I've always had a lower sexual drive

It depends on the partner

It depends on what's going on in my life

I've been matched before in sexual drive

I don't feel like I've ever been matched in my sexual drive

What would you say is true about how you feel about the female arousal process, including romance, foreplay, and education about the female sexual anatomy and how to turn a woman on?

I feel very confident

I feel somewhat confident

I don't feel confident at all

I feel totally lost

I feel like I know the physical part but not the others so much

I feel like I know about some of it but not all of it

Other

Which relational dynamic feels most natural to you in intimate relationships where you don't have to make an effort?

I naturally enjoy taking the lead and creating direction.

I naturally enjoy following my parters lead and responding.

I prefer when it naturally flows between us.

I prefer an equal exchange where leaderships flows back and forth.

It depends on the relationship and the moment.

I'm not sure because I feel like we've been stuck in patterns rather than being in what we want naturally.

Other

What would you say is true about your comfort level in communicating with a woman on an emotional level?

I feel very confident sharing my feelings and emotions

I feel confident for the most part

I feel like I could use more information in this area please

I feel lost

I feel like I need some skills and tools in this area

How many times would you say you've cried in the past year? Choose 10 if more than 10

What do you feel partners didn't really understand about you as a man?

What feelings would you say are the most common you've felt while in a relationship?

I didn't feel respected.

I didn't feel emotionally understood.

I didn't feel desired.

I didn't feel appreciated for what I provided.

Conflict was never resolved well.

We lost emotional intimacy over time.

We became more like roommates than lovers.

With 10 being 100% met, how much of your desired physical touch needs are currently getting met?

Which coaching pathway interests you the most?

Sexual Performance & Confidence - Overcome anxiety, dysfunction, and deepen erotic connection

Marriage Rewired - Rebuild intimacy, communication, and long-term partnership

Masculine Emotional Intelligence - Develop emotional depth and stamina

Somatic Intimacy & Nervous System Mastery - Regulate your body, expand presence, and create secure attachment

The Tantric Man - Learn the art of embodied sensuality and master lover

What is your preferred platform for learning?

I understand Elite Intimacy does not provide hands-on bodywork, but it can provide resources to locate practitioners who provide hands-on bodywork.

I understand

Other

Elite Intimacy Coaching can offer you lifelong, heart-centered, practical tools to tremendously enhance your vitality and stamina. It is designed to help you feel more of your heart, your body, and your emotions.

It isn't therapy, a sexual novelty experience, or a way to fulfill a fantasy or fetish. There are many resources I can connect you with if that is your desire. It is a truly unique experience with someone who has been humbled by her own vulnerabilities with love, intimacy, and sex. Together with her clinical research and expertise, it is truly an unparalleled experience for those genuinely desiring embodied pleasure and mastery. The first session starts at $300/hr. From there you can assess if you'd like to move forward at which point the mastery programs start at $1500 and then custom experiences can be tailored from there. Please check that you have read this and understand.

Elite Intimacy Coaching can offer you lifelong, heart-centered, practical tools to tremendously enhance your vitality and stamina. It is designed to help you feel more of your heart, your body, and your emotions.

I understand. I'm ready to be contacted for our initial session.

I understand and I'll contact you when I'm ready.

Other