Thank you for your interest in the Bespoke Receive and Reveal Retreat.

This transformative experience is tailored to your unique desires and needs, whether it’s a one-day immersion, a two-day/one-night retreat, or a multi-day journey.

To ensure we create the most aligned and impactful retreat for you, please complete the form below.

First Name

Last Name

Phone *

Email *

What is/are your preferred name(s)?

Social Media Handles (if using)

Time Zone

Age

Pronouns

Are you applying as

Individual

Couple

Desired retreat format (select all that apply):

Luxury hotel experience

Nature-based exploration

Intimacy and sensuality focus (e.g., boudoir photoshoot, pleasure mapping)

Other (please specify):

Preferred retreat length

One-day retreat

Two-day/one-night retreat

Multi-day retreat

Other (Please Specify)

What or who led you to Juliette and inspired you to reach out?

Briefly describe your current challenges or areas you’d like to focus on during the retreat:

What are you looking for support with? Please be specific!

What have you done to address these challenges? Please share details.

Have either you or your partner experienced any trauma, sexual or otherwise? Please be specific.

What are you hoping to gain from this retreat? What would you like to walk away with?

What has your healing journey looked like so far? Have you worked with a coach, mentor, or therapist before? If so, what was that experience like for you?

What in your life is working well?

What challenge have you overcome that you're most proud of?

What are your greatest triggers?

What in your life are you committed to improving?

Mental

Emontional

Physical

Spiritual

Relational

Family

Life Purpose

Are there specific elements you’d like included in your retreat? (e.g., boudoir photoshoot, somatic practices, shamanic experiences, etc.)

Are there any boundaries, preferences, or special considerations we should be aware of?

Location preference

UK (in-person)

Other location (please specify):

Other (please specify)

Would you like Juliette to travel to a location of your choice?

Yes (please note additional charges apply)

How did you hear about this retreat?

Please use this space for anything else you would like to share: