Couples Bondassage Intake Form - Enhance Connection in Oakland INTAKE FORM Leave this field blank Welcome! I look forward to learning more about you and what we might like to co-create together. (optional) CONTACT INFORMATION: Please provide your names and contact details in the appropriate sections below (optional) Your First and Last Names Your Email Addresses: Your Phone Numbers: (Please make the first phone number correspond to whomever is filling out the form. Thank you!) Phone Number #2 Your Preferred Pronouns: (optional) Your Ages: (optional) Your Occupations: (optional) Please provide website and/or LinkedIn or other active social media links for both of you that will help me verify your identities and complete your prescreening. (This is a required element before we can schedule.) How did you find me? (optional) WHAT INTERESTS YOU? Which of my offerings are you interested in exploring? (You can indicate more than one.) Bondassage couples session or customized mini-training ~ 3 hours In person at my work space Out call to your home (additional fee applies) Bondassage training for couples (half-day immersion ~ 4 hours) In person at my work space Out call to your home (additional fee applies) Bondassage training for couples (full-day immersion ~ 6 hours) In person at my work space Out call to your home (additional fee applies) Bondassage training for couples (full-day VIP immersion ~ 8 hours) In person at my work space Out call to your home (additional fee applies) Are there additional add-ons you might be interested in? Bondassage® Starter Kit ($300) Milking Table Massage Training ($500) Milking Table Purchase ($1100) Social Time After Our Session ($200/hour) One-off Or On-going Coaching Work Together ($260-$5000+) Erotic Blueprints Breakthrough Program self-guided online course ($1990) Please list some dates coming up that can work for you both. Fri-Sun from 12pm-8pm is my usual training schedule; however, other days & times can be made available with enough advance scheduling. What’s going on in your relationship currently that has inspired you to want to learn these new skills? What has inspired you to want to work with me specifically? Have you taken the Erotic Blueprint quiz? Yes No If no, please make a point to do so and email me both of your results to ladyclaire@youreroticevolution.com. You can find the basic quiz here: (optional) https://bit.ly/EBQuickieQuiz If you know your Erotic Blueprints, please indicate them here with your name next to yours. What are some intentions/outcomes you hope to achieve personally as well as for your relationship by training with me? Is there anything else you’d like to share about yourselves, where you currently are in your lives, significant things about your relationship, etc that will help me know you better? Are there any questions you have for me? Thank you Send