What's the biggest challenge in your relationship right now? *

Communication

Connection

Resentment

Intimacy

Trust

Other challenges?

UTM Source

What would a thriving relationship actually look like for you both? *

Open & honest communication

Feeling connected & on the same page

Feeling supported, appreciated & respected

Resolving fights quickly & easily

Deep emotional & physical intimacy

What can Save My Marriage School help you achieve that you can't with your current situation? *

If you couldn't fail where would you love to see yourself physically, mentally, and emotionally 12 months from now? *

This Breakthrough Session requires both partners present. Please confirm that both of you will attend. *

What is your level of commitment to overcoming your biggest relationship challenges and creating the relationship you really want? (with 1 being not committed and 10 being 100% committed?) *

1

2

3

4

5

6

7

8

9

10

Have you invested in a coach, program or your personal development previously and if so how much money have you spent on this? (This could be counselling, therapy, coaches, courses, programs, books or anything else that has helped your relationship) *

Yes. $100,000+

Yes. $50,000 - $100,000

Yes. $10,000 - $50,000

Yes. $5,000 - $10,000

Less than $5,000

No

Are you willing to invest time and money to learn how to save your marriage & completely recreate your relationship? *

Yes. I have the money and I am willing to invest both time and money to experience the relationship I deserve

Yes. I am willing to find the time and money to experience the relationship I deserve

No

Imagine you had a magic wand and you could overcome all of your current struggles & achieve the relationship of your dreams in less than 12 months. What would you be willing to invest in order to achieve that? *

$100,000+

$50,000 - $100,000

$10,000 - $50,000

$5,000 - $10,000

$1,000 - $5,000

Less than a $1,000

How did you hear about us? *

Facebook Post / Instagram Post

Facebook Ad / Instagram Ad

Facebook group

YouTube

Podcast

Email

Google

Other

First Name *

Last Name *

Email *

Phone (so we can SMS you reminders about your call) *

Your Partners First Name *

Your Partners Last Name *

Your Partners Email Address *

Your Partners Phone Number *