Hey there, what's your name? :-)
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What's your email address?
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What's your phone number? (Optional for contact via WhatsApp or FaceTime)
If I could wave a magic wand and help you achieve 1 thing in your relationship, what would it be?
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How will you know you’ve achieved the result you are looking for? How will achieving this outcome improve the other areas of your life?
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What are you doing already to get there? Include how much time and money you’ve invested in reaching your goal(s).
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What are your biggest challenges in your relationship with yourself and/or others?
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How are these challenges affecting your life?
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We ask that if you schedule an appointment, you agree to show up at your scheduled time or reschedule at least 24h in advance. Do you agree to this?
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Yes
No
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What is your current monthly income?
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0-$1000
$1000-$2000
$2000-$5000
$5000-$10000
Over $10000
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How much can you invest in your growth?
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$100
$500
$1000
$3000
Over $5000
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