Becky & Cory guarantee 100% professional confidentiality. Please read ALL instructions carefully, and fill this form out completely.


What is Explosive Sexual Healing?

Explosive Sexual Healing is somatic sex education that can include coaching in breath, movement, body awareness, boundary setting, communication, anatomy, sensate focus, erotic trance and other body-based teaching about sex. Explosive Sexual Healing is designed to nurture, deepen or awaken the sensual self. Whether you want to rid your life of feelings of sexual shame, better express your desires, or deepen erotic pleasure, we welcome you to this journey.

Explosive Sexual Healing practitioners are trained to include the genitals in sessions. Through this touch, we assist clients in developing presence within the body, opening interior awareness, and learning how the body can become more and more alive. We offer experiential learning opportunities that consciously access profound states of consciousness.

Be as detailed as possible when answering the questions below, as they will help guide our sessions. Spend no less than 1 hour and no more than 2 hours filling out this application.

You will be taking off your jewelry at all sessions, so be conscious of how much you put on before coming over. Please wear comfortable yoga-like pants to your Awakening Session for the full body massage. Also, most clients are more comfortable with a sports bra or no bra.

Name *
Name
Birthday *
Birthday
Phone *
Phone
Emergency Contact *
Emergency Contact
Emergency Contact Phone *
Emergency Contact Phone
Please Consider and state your deepest intention(s) regarding sexuality, eros, spirituality, life purpose and career goals.
Sexual history and information
Do you have any STD's? *
Do you have any scarring or pain inside your vagina from giving birth or from anything else? *
Do you orgasm from a vibrator on your clitoris? *
Have you experienced any kind of sexual abuse or trauma aside from anything mentioned above?
Are you currently on any medication? *
Are you on any kind of birth control? *