Apply to Work With Me
All responses are 100% confidential. If you are applying as a couple please submit only one application. After I review your application, I will email you a confirmation email with a link to book your Assessment and pay the $1500 fee. Assessment sessions must be booked and fees must be paid within 48 hours of the confirmation email. Please answer each question completely. Incomplete applications will be rejected.
Client #1 Full Name
*
First Name
Last Name
Client #1 Email
*
example@example.com
Client #2 Phone Number
*
Please enter a valid phone number.
Client #2 Full Name
*
First Name
Last Name
Client #2 Email
*
example@example.com
Client #2 Phone Number
*
-
Area Code
Phone Number
What are your 3 biggest challenges when it comes to the sex, intimacy, and/or communication in your relationship? (all responses are kept confidential)
Please describe your history with these challenges. What obstacles have been in the way of resolving it?
What programs, products, services or other solutions have you tried in order to solve this challenge and what have your results been?
If someone offered me the opportunity to invest in a high value program that could empower me to resolve my challenges in sex, intimacy and relationship I would:
Understand that is what someone would do if they were serious about getting help and making changes.
Feel hesitant at first but with a proven process I would do it because I am serious about making changes.
Avoid it at all costs because I prefer to do things on my own and as cheaply as possible.
When it comes to investing my financial resources to restore/improve our relationship:
I have the financial resources to invest in a solution
I can free up or have access to financial resources to invest in a solution.
I don't have any financial resources to invest in a solution
Do you have at least $6000-$10000 to invest in saving and/or improving your intimate relationship at this time?
YES
NO
NOT SURE
If accepted as a private client, how soon will you be ready to get started with the process:
Immediately
Within 1-3 months
Within 3-6 months
Longer than 6 months
If you had a fairy godmother who could sprinkle fairy dust over your intimate relationship, describe in detail the biggest changes you would like to see happen
Why do you think you would be a good fit to work with me?
Is there anything else you would like me to know?
I/we understand that this application is not a guarantee to work with Susan Morgan Taylor, MA. I/we understand that I am not a client of Susan Morgan Taylor, MA unless and until I/we have been formally accepted into the program and have agreed to and accepted all applicable terms and conditions. I/We understand that our application will be reviewed by Susan Morgan Taylor, MA, and if accepted, a confirmation email will be sent with instructions on how to book our formal Assessment session and pay the Assessment fee of $1500. I/We understand that Assessment sessions must be booked an fee paid within 48 hours of the confirmation email to avoid having our application cancelled. We understand that if my application is not accepted, I/we will be notified by email. By signing below I/we acknowledge that I/we have read, understand and accept the foregoing.
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