Relationship Intensive Application

1
What are the current challenges you and your partner are facing in your relationship?* This field is required.
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2
On a scale of 1-10, how committed are you and your partner to improving your relationship?* This field is required.
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3
Have you previously tried other forms of relationship counseling, therapy, or intensives? If so, what was your experience?* This field is required.
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4
If applicable, could you also estimate how much you have invested in these efforts so far?
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5
What would success look like for you after completing this Intensive?* This field is required.
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6
Are you able to financially invest in the healing and growing of your relationship? * This field is required.
YESNO
7
What is your first and last name?* This field is required.
First Name
Last Name
8
What is your primary email address?* This field is required.
example@example.com
9
What is your phone number?* This field is required.
Area Code
Phone Number
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