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Question 1 of 20
Phone Number:
Question 2 of 20
Location/Time Zone:
Question 3 of 20
DOB:
Question 4 of 20
Gender Identity:
Question 5 of 20
Relationship Status:
Question 6 of 20
Relationship Preference:
Question 7 of 20
What is the state of your overall health?
Question 8 of 20
What is a telltale sign that your body is under tension?
Question 9 of 20
What is your most familiar way to manage tension?
Question 10 of 20
On a scale of 1-10 (1 being the lowest and 10 being the highest), how satisfied are you with your current sexual experiences?
Question 11 of 20
What area of your sexuality do you enjoy the most?
Question 12 of 20
In a concise paragraph, describe the biggest concern or sexual roadblock you are struggling with?
Question 13 of 20
How do you feel about this road block and how it is affecting your life?
Question 14 of 20
Describe any destructive behaviors you engage in to lessen the pain around this roadblock?
Question 15 of 20
What is the biggest obstacle preventing you from living a fulfilling life/sex life right now?
Question 16 of 20
Briefly highlight any areas of your life that are thriving?
Question 17 of 20
What is your current knowledge of Tantra? Have you studied with anyone else? If so, when?
Question 18 of 20
Are you willing to integrate a regular meditation practice into your life?
Question 19 of 20
Which of these desired results apply to you the most (check all that apply):
Healing Past Wounds
Knowing Yourself
Embodying Confidence
Intimate Power/Intelligence
Connection With Partner
Enhancing Pleasure Skills
Living in Your Authentic Sexual Nature
Becoming a Better Lover/Sexual Mastery
Using Sex as Medicine
Other
Question 20 of 20
What do you think would make you an ideal client for Theano?