Which scenario describes your situation best?

What is your name?

What is your email address?

What is your phone number?

What country do you live in?


Describe your marriage/relationship.

What have you done to try to help?

What symptoms are you experiencing because of this?

What goals do you have for yourself and for your marriage?

What would it be worth to you to solve this problem?

It is extremely crucial that you have watched Sariah's webinar prior to the call

What is your biggest obstacle in achieving your goal?

Do you have the financial resources to invest in your healing?

If accepted to work with Sariah, how soon can you get started?

Is there anything else you'd like to tell me about yourself, your marriage, etc, that would give me a clearer picture of who you are?

Are you ready to release your emotional trauma, rebuild trust, and reconnect in your life (and your marriage)? Please type your initials in the box below to confirm you've answered these questions honestly, you're ready to learn, and are eager to grab one of the open spaces in my program.

By typing my initials, I grant permission for the company to contact me regarding the application and related inquiries.