Tell me about you.......

Hello Ladies,

This is a quick form for you to fill out, once you push SUBMIT at the bottom of the page - your answers will be sent directly to my email, so all answers are confidential and for my eyes only.

If you have any questions - please don't hesitate to be in touch,
I look forward to reading your responses.

Warmly
Katex

Name

First Name

Last Name

Email Address

Mobile Number

Date of Birth

What's your current form of birth control, and what have you used in the past?

How comfortable do you feel talking about sexuality - Is there anything you'd like me to be aware of?

How comfortable do you feel talking about menstruation? Is there anything you'd like me to be aware of?

Please describe your relationship with your body.

What's your current relationship with time?

What would you most like to transform in your life?

What would you most like to learn about, or what do you most hope to gain through this programme?

Is there anything you'd like me to be aware of, or that you feel I should know about?

T W E L V E M O O N S - Personal info

Tell me about you.......