Pleasure Liberation Assessment

This is an invitation to slow down and notice what is already asking for change. Please respond honestly and intuitively, noticing what feels most true in your body. There are no right or wrong answers.

I will carefully review your responses and discuss your results with you during your upcoming Discovery Call so we can determine what support will best serve you.

Your Information

First name

Last name

Pronouns

Age

Race/Ethnicity

Gender

Religious or spiritual orientation

Differently Abled/Disability Status?

Highest Level of Education

Current Occupation

Relational Orientation

Sexual Orientation

Your Relationship to Pleasure

1. How close do you currently feel to your own pleasure, desire, and sense of aliveness?

2. How often do you hold back or soften your desires out of fear of being “too much,” disruptive, or destabilizing?

3. How much shame do you feel around your desires, fantasies, or longings?

4. How connected do you feel to your erotic aliveness, not only sexually but emotionally and energetically?

5. How worthy do you genuinely feel of pleasure, fulfillment, and relational honesty in your own life?

6. How constrained do you currently feel by inherited relationship scripts around monogamy, gender roles, desire, or commitment?

7. How safe does it feel to tell the full truth about your desires, boundaries, and curiosities in your relationships?

8. How willing are you to examine your own relational patterns, even when doing so challenges familiar narratives or self image?

9. How prepared do you feel to stay present through discomfort, uncertainty, jealousy, grief, or relational growing pains in service of deeper pleasure and integrity?

10. How committed do you feel right now to liberating your pleasure and choosing a more authentic, aligned way of relating?

Your Lived Experience of Pleasure

11. What feels increasingly unsustainable, constricting, or painful about the way you are currently relating?

12. If nothing meaningfully changes in the next year, what do you sense this will cost you emotionally, erotically, or relationally?

14. Imagine you have been working with Dr. Nicole for some time and your relationships now feel honest, pleasurable, and aligned with your values. What positive changes would you notice in your day-to-day life?

15. Each year, Dr. Nicole works with only 10 individuals or couples/polycules, and 9 group participants per cohort at a time. Knowing this, why do you feel called to be one of them?

[Optional] Is there anything else you would like to share with Dr. Nicole?