Elevated Dating™ Coaching Application
Please fill out this application to help me understand your dating journey and goals. Your answers will guide me in providing the best coaching experience.
Full Name
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Email Address
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example@example.com
Why are you applying for Elevated Dating? What brought you here right now?
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What has your dating experience been like in the past? What patterns or experiences stand out to you?
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What do you want your dating life to look and feel like?
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What is your biggest struggle when it comes to dating?
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Are you ready to date differently, with intention and confidence? Explain your yes.
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What are your current relationship goals?
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Casual dating
Intentional dating
Long-term partnership
Marriage
Rebuilding confidence after a breakup
Other
Do you feel you have healthy standards and boundaries? If not, what needs strengthening?
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What is your attachment style, if you know it? (If you don’t know, simply say “not sure.”)
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What type of partner do you feel most aligned with? Describe the qualities and energy you desire.
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What do you hope to gain from this program?
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Is there anything else you want to share with me before I review your application?
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