Discovery Session Form

Application Form For Your Perfect Partner Discovery Session
The one-on-one 30 min discovery session is laser-focused and designed to cut through the chase to help you gain clarity on your process of finding the perfect partner. You will work with Patty to identify:

- Your top priorities so you know what to do first to attract your perfect partner.
- Your current situation, including disempowering beliefs getting in the way of you meeting the right partner.
- New ideas and immediate steps you can take now to get started.
Your Name *

First Name Middle Name Last Name
Birth Date *

Day Month Year
Gender *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
E-mail *
example@example.com
Mobile Number *

Country Code Area Code Phone Number
Questionnaire:

Pls fill out as much you can...
What are the three biggest obstacles stopping you from meeting your perfect partner? *
What's the greatest outcome you'd like to see as a result from the discovery session? *
How serious are you about finding a new partner? *
Disclaimer
This discovery session doesn't guarantee any success or is promising your future relationship.

This breakthrough session is not for everyone and therefore not all applications will be considered.
Read and Understand the Disclaimer *

Yes, I have
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Application Form For Your Perfect Partner Discovery Session