Pre-Booking Questionnaire

Before You Begin

Your privacy matters. The purpose of this questionnaire is to help me understand you, your intentions, and what you’re looking for so that I can determine whether my work is a good fit for you. There are no “right” answers. Please answer honestly and share only what you feel comfortable sharing.

I screen all new clients before a first session to ensure this work is safe, respectful, and a supportive fit for both of us. Sessions require clear intentions, emotional readiness, and strong boundaries. A brief intake process helps confirm that we are aligned and that I can best support you.

I will be in touch within 24 hours with next steps for booking.

*All fields are required*

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Thank you for your response. ✨

Name (First and Last)

Town/City & State you are visiting from

Phone

Preferred Contact Method (If Email is selected & a response isn’t received within 24 hours, please check your spam folder or text 603-340-5143)

Date of birth

YYYY-MM-DD

How did you hear about me?

Per industry standard, I require identity verification before scheduling new clients.
Are you willing to present a recent photo?

Are you willing to fully respect session agreements and boundaries?

Tell me about yourself. What are your interests and what do you do for work? Please share anything you feel would be helpful for me to know about your current circumstances or relationships.

What drew you to this work? What are you hoping to experience, explore, heal, or understand through this work? Have you worked with a practitioner in this area before?

Intimacy Guidance & Tantric Bodywork

with Theresa Marie

Pre-Booking Questionnaire

Thank you for your response. ✨