Name *

First Name

Last Name

Preferred Phone Number *

(###)

###

####

What is your preferred initial method of contact

This is what I'll use first to reach out to you.

Email

Phone call

Text

Smoke Signals

What kind of session are you looking for? *

For descriptions of each, watch the video below. Video Sessions 2:30 Energetic & Touch Coaching 4:19 Empowered & Supportive Cuddle Sessions 6:08 ReTouch Sessions 9:23 ReMothering Sessions 12:20 Surrogate Partner Sessions 14:48 OTHER Explained 16:45

Video Session with Me as Your Guide $80

Video Session Individualized to Your Needs $100

Energetic Coaching Session $100

Empowered Platonic Touch/Cuddling Session $80

Supportive Platonic Touch/Cuddling Session $100

ReTouch: Rehabilitative Touch Therapy $120

ReMothering Sessions $120-300 (Watch YT video for more info)

Surrogate Partner Session (Pre-requisite Intake with Dr. Susan Kaye or Talk Therapist First) 90min $200

Other (Share more in your notes below)

Your preferred location(s) for your session? (

Travel Fee: $20 fee within 10mls, $40 for 10-20mls

MY STUDIO SPACE: couch, Lovesac, bed, outdoor evening setting for cooler weather, hammock, etc

YOUR HOME/HOTEL, Travel Fee Required. No fee for people with disabilities

A FAVORITE PUBLIC PLACE, e.g. restaurant, café, park, Travel Fee Required (unless it's a walking coaching session. Travel Fee waived)

General COMPANIONSHIP to a location you'd love my company: athletic game, dancing, concert/theater, festival, etc

Your therapist/medical APPOINTMENT, Travel Fee Required

Other