Sacred Love Counseling Questionnaire

* Required

First please tell me your name:

Would you like to receive my FREE Sacred Love Newsletter by e-mail?

List several time options that you are available for a session Monday through Thursday from 9:30 AM to 6:00 PM PCT. (Please give your top three, in order of preference.)

What is your telephone number?
If applicable what is your Skype contact information?
When is the best time to reach you to set up the session?


Karinna may use some or all of the following in her counseling session with you, the participant(s): Discussion, Breathing Techniques, Rituals, Fit For Love Exercises, and/or Meditation. It is advised to wear loose comfortable clothing. Nudity is not permitted during a counseling session. The participant(s) agrees and understands that the techniques are taught with respect and integrity and the participant(s) must also participate in the session in a respectful manner. The participant(s) also agrees and understands that neither Karinna Kittles Karsten nor Sacred Love® Inc. will be held liable for any injury sustained while participating in any of the Sacred Love® techniques and exercises.

What personal intentions and goals do you wish to address in Sacred Love Counseling?

If applicable, what intentions do you wish to address in your intimate relationship?

What are the areas you are most interested in developing? (Hold the CTRL key and click to select all that apply)

If applicable, please tell me anything else I should know that you are expecting to get out of this session.

Please enter your billing information.

What's This?

Thank you. You should hear a response within three to five business days by phone or email. Which is your preference?

I look forward to speaking with you soon. Wishing You Sacred Love, Karinna