Application Form for Cancer and Intimacy Coaching

Welcome! I’m honored that you’re here.
This form helps us begin from a place of shared care, clarity, and intention so we can get a sense of whether working together feels like the right fit for your healing and growth. If you are in a partnership, I ask that each of you submit an application separately.
Thank you!

Section 1: Basic Information

How may I be of service?

Section 2: Cancer & Healing

Section 3: Intimacy & Communication

Section 4: Previous Experience(s)

Section 5: Final Reflections

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