Relationship Rescue

1

Email

example@example.com

2

Name

First Name

Last Name

4

What are your biggest challenges right now in the relationship?

5

What does your ideal relationship look like? Can you describe it?

6

What has stopped you from experiencing your ideal relationship?

7

What are your relationship goals over the next few months?

8

On a scale of 1 - 5, how committed are you to solving the problems, and how willing are you to learn new ways of relating??

1 Not committed

2 Slightly Committed

3 Committed

4 Very Committed

5 Extremely Committed

9

Why is the relationship important to you?

10

Are you willing to invest your time and money to guarantee the future of your relationship?

11

What happens if things don't improve, where will that leave you?

12

If we schedule a time to chat, do agree to be on the call?

YESNO

13

If you cannot make the call, do you agree to reschedule.

YESNO

14

Thank you. If you haven’t already scheduled a time in Calendly, please specify some days and times below, and I'll check if I have space.