Contact — Danielle DeLora

Contact Me

I’m honored to be part of your sexual wellness journey! Please submit some information about yourself (and your partner) to determine if we’re a good match for your goals.

Name

First Name

Last Name

Phone

(###)

###

####

City/state of residence

Profession

Tell me about yourself!

What are your/ your partner's current challenges? What are you currently doing to address the issues? What are your goals for working with me? What should I know to best serve you?

What kind of experience is this?

When would you like to see me, and for how long?

Anything else you'd like to include?

Deposit/Cancellation Policy *

• Professional verification and/or provider reference is required for all new clients, no exceptions.

I acknowledge that I may be asked for a deposit to hold my desired date. Should I cancel my date with 24 hours notice or less, a 50% cancellation fee is required.

Should you prefer to contact me directly via email, you can do so by sending the above information to danielle (at) danielledelora (dot) com.