Appointment & Tuition Enquiry Form

Please complete all relevent fields

First Name *

Last Name

Your Email *

Confirm Email *

Contact Number *

Would you like me to call or text you back to discuss the appointment? *

I am / We are *

Age(s) *

Sexuality *

I regard my physique as *

I/we want a treatment given by *

Service Options For Women

Service Options For Men

Options For Couples

Have you had a massage before? *

Requested Date and Time (write TBC if not sure) *

How Would You Prefer To Pay For Your Service? *

Please tell me your motivation and expectations for the massage or tuition you are interested in. Give details about any past experience in sensual/erotic bodywork, your current health or any other facts that may be relevant to taking a sensual massage, psychosensual treatment, coaching or tuition with me.

Motivation, Expectations & Health

How did you hear about Intimacy Matters *

Notifications & Exclusions to Massage

The sensual massage for men and women unless requested not to includes intimate contact and arousal to orgasm which by its nature increases heart rate. Therefore sensual massage is NOT suitable for anyone with the following conditions:

1. You are over 125 kilos or have a BMI over 35
2. You are diagnosed as either severely or morbidly obese
3. You suffers from a serious heart condition or has had a recent heart operation
4. You are taking medication for a heart condition
5. You have an untreated STI
6. You are seeking just sex
7. You have a virus, bacterial symptoms or serious skin condition
8. You do not have a normal temperature
9. You display any symptoms of Covid 19

In the cases of skin disorders, epilepsy or if you suffer from fits have high blood pressure or have an STI or are HIV positive, please discuss your condition with Colin before making the appointment.

IMPORTANT:

To send this form, you need to choose the option below that gives me, Colin Richards, consent to use and store your data.

Data Consent *

I send out regular updates on special prices events and features on sexuality please indicate if you want to be included in this mailing list. You can unsubscribe at any time.

Mailing List *

IMPORTANT: If you do not hear back from Colin within 24 hours please complete this form again or call Colin at 07966522696 or email colin@intimacymatters.co.uk