Before continuing with this form, please confirm: "I have read "Tantra With Tanya - Introductory Information" and "Tantric Coaching for Couples"
Yes (If you have not, please do so before submitting this questionnaire.)
If you choose to learn Tantra with me I would like to learn something more about you both. I would appreciate it if you would answer the questions below. Each partner should answer each question, separately and independently. Thus, we expect to receive two forms. Please relate the questions to yourself.
First Name:
Last Name:
Age:
City:
State:
Occupation:
Home Phone:
Cell Phone:
E-Mail:
What is your partner's name?
Partner's E-mail:
Please tell me about your relationship. How long have you been together? What is working? What is not?
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? What are your sexual aspirations? Please tell me about any sexual problems and concerns that you would like me to attend to. For example, if you have problems with getting an erection, in having an orgasm or feeling sexual desire, or difficulty in getting aroused without involving fantasies that you would rather not have, please let me know about it.
If you are a man, when you have intercourse, typically how long do you last from the time you enter until the time you ejaculate? If there is a range, give me the low and high end of the range and the most frequent or typical length of time.
Are there any changes you would you like to see in yourself and/or in your partner? If so, what are they?
Do you have any physical or sexual health problems?
What draws you to Tantra? . How can I best serve you? What exactly are you most looking for? If you got what you wanted, what would it look like?
Do you prefer to work with me alone or with me and my Tantric partner, Daka.
Do you have any reservations about doing private Tantra sessions or working with a couple? If so please say what they are.
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 1: Tantra Mastery Session - to learning the Tantric skills and consciousness that will enable you to create your own Tantric experiences. To experience the union of your sexual and spiritual energies as part of the intimacy you share together.
Option 2: Tantra Mastery Session - the development of your ability to be excellent lovers with each other - focus on actualizing your potential.
Option 3: Tantra Mastery Session - the development of your ability to be excellent lovers with each other - focus on solving sexual problems.
Option 4:Tantra Mastery Session - the development of your ability to romance your relationship and build your emotional and sexual intimacy with each other.
Option 5: Tantra Mastery Session - a series of sessions to achieve one or more of the above results. Please state what these results are.
Option 6: Tantric Experience - A Romantic, Tantric Experience. A magical, sensual, erotic, one of a kind, experience to juice up your life together.
Option 7: Tantric Experience - An Exciting, Boundary Stretching Erotic Adventure to explore your boundaries as a couple.
When do you wish to see me?
Comments:
Please indicate your preferred length of session time:
What website did you find me on?
Do you have any comments or questions that you wish to ask me? If so, please let me know what they are.
Comments and/or Questions:
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:
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