Re:Desire Application [Website]

Apply for Re:Desire Here

All the information you submit is completely confidential and will be reviewed be me (Leigh). I want to make sure my expertise matches your challenges, and the information in this form helps me make a professional assessment as to whether this is the right program for you or not.
What is your first name?*
What is your last name?*
What are your pronouns?*
How old are you?*
What country do you live in?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What is your preferred email address?*
So I can email you all the details about the program and the private training!
What's your mobile phone number?

Country CodeArea CodePhone Number
Don't worry, I won't be calling you! This is so I can text you all the details about the private training (so you don't need to keep a check on your email all the time!)
Describe in detail what you’re hoping to experience by joining Re:Desire. Eg. What does your sex drive, sex life and relationship look like now? What are you hoping will happen with your sex life and relationship by joining this program? Don't hold back, I want to know it all! And the more I know the more I can determine if Re:Desire is the perfect fit for you or not. *
The program requires you work holistically with your sex drive. This means we’ll address your relationship with sex, your relationship/marriage, emotions and thoughts. Are you experiencing any mental health challenges right now that would make working on a deep level in this program, difficult for you? *
Eg: ongoing depression that you're not treating, PTSD, or extensive difficulties with anxiety? Please know previous mental health challenges do not disqualify you - I just want to make sure my expertise and the scope of Re:Desire is the best fit for you. All your answers are, of course, completely confidential.
What does your partner's desire look like?*
All personal data submitted to us through the application form or other means will be processed by us in accordance with our privacy policy. By submitting personal data you consent to such processing.

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Website
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Apply for Re:Desire Here