Application to Work w/Ryan Thomas & Get Them Back

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Helping Parents Reconnect with their Children

***Please Fill Out This Application To Work with Ryan Thomas' Get Them Back***

FINANCIAL CHECK

Before we move forward, we want to make sure, if accepted, you are financially qualified to join us. This opportunity is only for people with income and who want to invest in rebuilding the relationship with their children. It is also for those who can appreciate a higher level of service and guidance, have a growth mindset, and see the opportunity to save the relationship with their child as a priceless investment.

We’ve seen a common theme throughout or program: Parents who are extremely driven and have a track record of success in other areas of life do extraordinarily well working with us.

Please know we do not offer scholarships or financial aid of any sort. We intentionally like to keep our group small to provide the most customized guidance. If you are someone who absolutely wants this coaching support - and we determine you are a great match for the Get Them Back program, we do accept all major credit cards.
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What's your name?* This field is required.
First Name
Last Name
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What title best describes you?* This field is required.Mom, Dad, Grandparent, Step-Parent, etc.
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What's your email address?* This field is required.We will use this to reply to you.
example@example.com
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What’s your phone number?* This field is required.
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What are the names and ages of your ALIENATED children?* This field is required.
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Do you have any other children that are not alienated?* This field is required.YES/NO - please list their names and ages if yes.
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Are you...* This field is required.
Divorced
In the process of getting divorced
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Are you currently involved in the legal system with a court or custody case?* This field is required.
YES
NO
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Were you referred by anyone?* This field is required.(If Yes, who? Person's Name, Youtube, Facebook, Instagram, LinkedIN, etc?)
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How long have you been rejected?* This field is required.
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How much access do you have to your child or children?* This field is required.
NONE
NONE (Legally Prohibited) - This may prevent our ability to help
Extremely Limited
Limited
Full Access
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Describe your access and what you can and can not do....* This field is required.
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Who is alienating your child from you?* This field is required.Other Parent, Grandparent, Son-in-Law, Daughter-in-Law, etc.
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What are the top 3 core challenges you want to fix?* This field is required.
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What do you feel you need to do better? (please be as detailed as possible)* This field is required.
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Briefly share your story with only the most important details.* This field is required.
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What do you want your relationship to look like 12 months from now?* This field is required.
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Which solutions have you tried? (Select all that apply)* This field is required.
Books
Online Courses
Workshops
Reunification Therapy
Counseling
Legal/Court System
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How much have you spent trying to resolve this?* This field is required.
$1,000-$10,000
$10,000-$50,000
$50,000-$100,000
$100,000+
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Why do you think those "solutions" haven't solved the problem yet?
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How has being rejected effected you? (Select all that apply)* This field is required.
Stress & Anxiety
Feeling lonely & isolated
Trouble Sleeping
Health Issues
Frustration & Anger
Strain on other relationships
Impact on Job Performance
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Based on your situation, what are your biggest fears? (Select all that apply)* This field is required.
I’ll never see my child again
Everyone will turn against me
I will fall into a spiral of sadness and depression
I’ll miss out on sharing a life with them
My child will think I am bad or evil
My efforts will be seen as me “buying their love”
My child won't know how much I love them
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What issues do you struggle with emotionally because of all this, and how does it affect your mindset?
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What will you miss out on in your child’s life if you don’t rebuild the relationship?* This field is required.
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What do you think will happen to your child if YOU are not in their life and they are only influenced by the other parent?* This field is required.
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What do you think your relationship will look like in 3 years of nothing changes? ** This field is required.
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What excites you about working with us?* This field is required.
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How soon are you looking to work with us, if it's a good fit?* This field is required.
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We have select enrollment periods throughout the year. Which enrollment period are you interested in?
February 6, 2023
September 2023
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Why do you think you would be a good client?* This field is required.
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Is there anything else we should know?* This field is required.
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To get to know you better, what type of work do you do?* This field is required.
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Finally, describe yourself when you are at your BEST.* This field is required.
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