Before continuing with this form, please confirm: "I have read "Tantra With Tanya - Introductory Information" and "Tantra Coaching for Women"
Yes (If you have not, please do so before submitting this questionnaire.)
First Name:
Last Name:
Age:
City:
State:
Occupation:
Home Phone:
Cell Phone:
E-Mail:
What is you relationship status? Tell me a little about your relationship history - just an overview and an update on the present and recent past.
How you would describe yourself from a spiritual perspective? Do you have any background in Tantra? Have you seen any other Tantra teachers who are up on the web? If so, please describe what you have learned. Are you, or have you been, involved in meditation, yoga, or any other form of spiritual discipline? Have you done any personal growth experiences in the form of workshops or trainings?
How you would describe yourself from a sexual perspective? Please tell me about any sexual problems and concerns that you would like me to attend to?
Do you have any physical or sexual health problems?
I would like to know what draws you to Tantra. How can I best serve you?
Which of the options below are applicable to you. Several of them over-lap but by choosing one over another I get to see what your preferences are. If several of the options are important to you and some have a higher priority, please list them in order of priority
Option A. The actualization of your sexual and spiritual potential through the Tantric path.
Option B. To find sexual bliss and sacred love with a current lover
, future lover
.
Option C. To heal sexual wounds.
Option D. To imbibe the spiritual basis of Tantra. To uncover/express your own sacred, sexual nature.
Option E. To experience a sacred, sensual connection with a woman.
Option F. To learn how to be orgasmic or more consistently orgasmic.
Please indicate which of these apply to you:
-
a. have not yet had an orgasm
-
b. don't know if what you have is an orgasm or not
-
c. keep riding the peak but never quite fall into the orgasmic abyss
-
d. have experienced orgasm but can rarely get there, or have difficulty getting there - want to learn how to orgasm consistently
-
e. get there too rarely for yourself and your partner
-
f. there is only a very narrow range of stimulation that can bring you to orgasm
-
g. want to learn how to have orgasm
-
h. want to learn how to have multiple orgasm
-
i. want to learn how to have full body orgasm
-
j want to learn how to experience female ejaculation
-
k. something else (Please describe)
Comments:
Do you have any questions that you wish to ask me? If so please let me know what they are.
Do you have any reservations about learning Tantra? If so please say what they are.
When do you wish to see me?
Please indicate your preferred length of session time:
What website did you find me on?
I am located and teach in San Diego but plan to do some travelling. Please let me know what cities you would like to be notified about if I visit them. Even if I am not going to your city, I may even be able to do a stop-over if it is on the way to a destination that I am headed to.
Location you would like me to travel to:
And, if you have alternate locations please indicate:
|