Pleasure on Purpose Application

Welcome to The Pleasure on Purpose Healing System. This is your application and is your first step on your life changing journey with us.

Please be as detailed as possible when answering the questions below. Spend no less than one hour filling out this application. The deeper you go in this, the faster your results. We understand that you may not remember everything and that is okay. Do your best. Your subconscious does remember and everything that needs to come out will present itself to us in your sessions.

Answering these questions will probably bring up some old memories and feelings that may be uncomfortable. This is all perfect and part of the process! Trust that these are exactly some of the things which are most likely holding you back and want to be deleted from your body memory.


POP Application - *You must fill out all required fields except for ones that do not apply to your gender. You will receive a confirmation email and a copy of all of your answers. Either Heike or Jonathan will then have a phone call with you to go over your application and answer any questions prior to your first sessions.

First Name*

Last Name*

Your Email*




Postal Code/Zip


Emergency Contact & Phone Number & Relationship to You

Skype ID

How did you hear about us?

Full Birthdate with Time & Location

For the following questions, please consider and state your deepest intention(s) regarding sexuality, eros, spirituality, life purpose and career goals:

What are you currently doing for a living, and what would you do if you could do ANYTHING? If You're already living your life's purpose, what would the next step be? Dream BIG.

What is your intention for these sessions? What is it you REALLY want out of life? Are you feeling called to a higher purpose?

What are you currently doing on behalf of your intention? What have you already done?

What do you feel is keeping you from having what you want?

Please develop 3-5 affirmations that if you believed on a deep, unconscious cellular level, would allow you to have exactly what you're looking to get out of these sessions. Make it short, sweet and powerful, and make it in the present tense. The most commonly needed beliefs are "I love myself," "I trust myself," "I forgive myself," "I am powerful," "I am wealthy" and "I am safe."

Family Information:
Are you currently in a relationship? For how long? How happy are you in it? Any previous relationships that have impacted you?

Do you have children? What's your relationship with them?
Any miscarriages?
Have you ever had an abortion?

Whats your relationship with your mother?
With your father?
Do you have siblings? How connected are you with them?

What was your childhood like?
Did religion play a role in your upbringing?

Sexual History and Information:
Please describe the sexual education and messages you received about sexuality while growing up.

Please describe any key sexual experiences and how you feel those experiences affected you.

Please describe a peak erotic experience. Think of your best erotic experiences. (What was happening? Was it alone or with a partner(s). What were you thinking? Feeling?

Wonderful or difficult things from my sexual/sensual HISTORY I want you to know are:

Wonderful or difficult things about my CURRENT sexuality/sensuality I want you to know are:

What is the most predictable way for you to orgasm? What puts you over the edge? Briefly describe your ideal sexual encounter, step-by-step, explaining what you like, i.e, nipples squeezed, fingernails on back, hand around the throat, genital touch, etc.

What is your masturbation practice like? Frequency? Duration? Method?

(Men Only) How often do you watch porn?

(Men Only) Have you experienced erectile dysfunction?

(Women Only) What is your experience with G-spot orgasm and/or female ejaculation?

If you have a partner, do they know you are receiving these sessions and are they supportive? We only work with women who have their partners fully on board, so Jonathan is happy to talk with them.

What word do you use to refer to your genitals during sex (i.e., yoni, vagina, pussy, kitty, penis, lingam, cock, etc.)

Do you have any STDs? If so, which ones?

Have you experienced any kind of sexual abuse or trauma aside from anything mentioned above? If yes, please describe.

(Women Only) What was the date of your last period? The best times for a session are when you are ovulating and when you are on your period.

Are you currently on any type of medication? If so, for what?

Do you have ANY medical or other body pain we need to know about? These sessions can be physically intensive.

(Women Only) Are you on any kind of birth control?

(Women Only) Do you have any scarring or pain inside your vagina from giving birth or anything else?

(Women Only) Do you orgasm from a vibrator on your clitoris?


I understand that all erotic touch will be given only at my request and solely for my own benefit, education and pleasure.

I have stated all medical conditions that I am aware of, and I will update practitioners on any changes in my health status.

I understand that we do not act as surrogate partners. They remain clothed, and touching is one-way only.

I understand that hygienic protocols will be used.

I understand that Pleasure on Purpose is not psychotherapy or medical treatment. I will consult my medical doctor if I have any question about my physical or mental health.

Due to rapid growth, prices are subject to change at any time. If client misses an agreed payment for any reason, they will be subject to the current prices at the time they continue with their next payment. Client’s price is only guaranteed while maintaining the agreed upon payment schedule.

I declare that I am above the age of 18 and that I will present a valid form of picture identification at my first session.

Cancellation Policy: 24 hours notice for cancellations is required or you will be billed for the session.

Refund Policy: I understand that there are no refunds for this work once the application is submitted.

Type Your Name Agreeing to All Statements Above