Name *

First Name

Last Name

Our programs are “safe” and private. Can you commit to keeping other women’s dance or healing journeys private, and not take selfies or videos in class until the agreed upon time, if any, and never take anyone’s photo intentionally or accidentally in the studio or Zoom or other movement space? *

Yes

No

Unsure

Do you have a medical or psychological history that might impact your ability to benefit from our offerings? *

Yes

No

Honoring agreements, especially those you make to yourself are important. Do you consider yourself someone who commit to showing up for your coaching program and commit to your healing, barring emergency, and/or commit to arriving at class on time barring emergency? *

Yes

No

We give lots of permission and modifications. Are you comfortable listening to your body and honoring her physically, especially if the suggested movement is strenuous and beyond your current capabilities? *

Yes

No

Unsure

Do you have experience with embodied movement, flow yoga, moving on your breath, or feminine movement?

Yes

No

Do you have a basic understanding and appreciation of the benefits of women being able to readily access their feminine energy and to heal old sexual and body messages?

Yes

No

Unsure

What is your comfort level or hesitation moving in space with other women, privately 1:1, in-studio, in-home, or virtually?

Very Comfortable

Somewhat Comfortable

Neutral

Somewhat Uncomfortable

Very Uncomfortable

The best programs are usually taught by someone with considerable education and experience, and when followed give the best results, knowing we make the offer and provide the expertise and tools to lead you there, and you are in charge of your healing journey. Can you comfortably commit to the financial exchange our programs entail?

Yes

No

Unsure