The Art of Intimacy Application

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
What made you reach out about getting some help with your relationship at this
4
How long have you been together?
5
How often are you currently being intimate with each other?
6
What are your biggest relationship challenges that you’d like me to help you with?
7
Have you taken any steps to solve these challenges? If so what didn’t work?
8
Is there anything standing in the way of you taking action to get started with putting the spark back into your relationship? (time, money, other commitments?)
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: