Name

First Name

Last Name

Pronouns

Confirm email

How did you hear about us?

Tell us how you are interested in being held in this offering.

1:1 with Amanda (and you are a woman of any orientation or a queer identified individual)

2:1 with Amanda and Tom (and you are a woman of any orientation or a queer identified individual)

2:2 with Amanda and Tom (and you are a couple of any gender, orientation and relationship structure)

Unsure

If you interested as a couple, please share your partner's name. Note: We will contact both of you about scheduling when we have received this form from each of you.

Why are you interested in The Temple of the Beloved?

What do you most want in your life right now in the realms of sex, love and intimacy?

Please share about any current practices, joys or activities that resource you.

Have you experienced or been treated for severe psychological trauma, abuse or psychosis? If yes, please specify.

While not necessary, we are curious if you have any experience being held in a container centering intimacy, embodiment, or something related, whether 1:1, 2:1, 2:2 or in a group?

We are currently booking TOTB in the Pacific Northwest (including Portland, Oregon & Columbia River Gorge), and Upstate New York (Rochester, NY) for spring and summer 2025. Which location works best for you? If you wish us to travel to you, (with travel expenses paid), please indicate "Other."

Portland, Oregon

Rochester, NY

Other

Do you have any limitations or disabilities we should know about?

TOTB is an experience that requires an investment of time, money and energy. Do you have the resources in your life right now to support you should you decide to move forward? General Pricing - 1:1 $250/hr; 2:1 & 2:2 $500/hr

Is there anything else you'd like us to know about you?

Next steps - we will get back to you within 3-5 days to schedule a complimentary 30 minute Zoom call. Please let us know your general availability and time zone below.

book a consult