Intake form | Alana Dayne Elemental Tantra

Client intake form

Welcome to Alana Dayne Elemental Tantra. To ensure we can best support you on your healing journey, please take a moment to complete this intake form. Your honest responses will help us understand your unique needs and aspirations, preparing us for a meaningful initial consultation. We are committed to fostering lasting transformation, not just quick fixes.

Get in Touch with Alana

Name *

Email address *

I identify as: *

She/Her
He/Him
They/Them

Are you seeking sessions solo or with a partner? *

Solo
With a Partner

Please give detail regarding what ou are seeking and what you would like to overcome and heal in your life: *

*Please note that if you are looking for an erotic massage, this is not the place for you. I teach self somatic practices to help rewire your nervous system. Please indicate that you understand and accept *

I understand that nudity and eroticism are NOT part of sessions with Alana and agree not to solicit in this regard. If I do not adhere by this rule, I understand that the the session will be terminated and no refund will be given.

Are you seeking in-person or private virtual sessions? *

In-person in Manitoba
virtual sessions via ZOONM MS Teams, WhatsApp, Facetime, etc.
A combination of both in-person and virtual sessions.

Once you submit your form, Alana Dayne will review it and will reach out to you via your preferred method of contact, if she feels the information you have provided is sincere, to schedule your intake session. These Initial consultation sessions are conducted virtually via Zoom, MS Teams, WhatsApp, or other convenient platforms, ensuring accessibility and comfort. NOTE: All information is kept in the strictest of privacy and confidentiality and governed by a strict code of ethics.

Location

Manitoba, Canada