www.tantrabyronbay.com

Tantra byron bay. com

~ Phone: 0425 347 477 ~

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NEW client Application Form

Thank you for taking a few minutes to fill out a New Client Application Form. This form is not essential, however it will assist me in better preparing for your session before you arrive.

Your Name
Contact Ph No:
Email Address
What type of session are you booking for?
- Mens Session
- Womens Session
- Couples Session
What is your motivation for having a session/s? Please describe...
What are your goals for your session? Please describe..
Do you have any issues that you would like to work upon? Please describe..
What sacred sexuaity/tantra work have you experienced before?
Are you in a committed relationship? If so, how long?
Are you taking any medications? Please describe
Do I have your consent to call you or txt you about your appointment?
- Yes
- No
- Prefer Txt
- Prefer Phone
Do I have your consent to email you?
- Yes
- No
Send Message

Thank you for contacting us. We will get back to you as soon as possible

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