Intake Form

Thank you for booking a session. Please set some time aside to fill out this form as completely as you can before your appointment. This is a secure form; your information will be kept private in accordance with my privacy policy.

If you have not yet booked a session, click here or email to get started.

Thank you for your responses.

Sex coaching assists clients with matters such as sexual intimacy, personal challenges, and relationships. A coach is in a partnership with the client to help improve their personal life. The focus is to help the client consciously create a vision and goals for life. Coaching helps clients think differently and learn what’s best for the individual. Coaching is not therapy or counseling.

These services do not include the practice of medicine, psychology, or counseling. I, as a client, agree that I am fully responsible for my physical, mental, and emotional well-being, including my choices and decisions while engaging in these services. If I am under the care of a mental health professional, I will make the mental health professional aware of my sessions with Shannon Burton. If any type of counseling or mental health treatment is needed, the client is to be referred to individuals who provide that care.

I understand that identifying personal information will be held confidential except as required by law.