Ruth Collective Intake Form

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

4

CIty and State/Country

5

What is it you want right now?* This field is required.

6

Tell me about your journey so far. What have you already tried — therapy, coaching, dating apps, advice from people around you — and what's actually moved the needle? * This field is required.

7

What feels like it's been standing in your way?* This field is required.

8

How would you describe your faith right now?* This field is required.

Strong and central to my life

Present, but I want to grow in it

I respect faith-based wisdom, though I'm not religious myself

Not a major factor for me

9

How would you describe your timeline?* This field is required.

I'm playing the long game-doing this right matters more than doing it fast

I'd love to see this resolved within the next year

I feel real urgency. I don't want to waste more time.

Type option 4

10

When you think honestly about what's held you back, are you looking at one clear thing, or several things tangled together?* This field is required.

One clear thing

A few things that feel connected

Honestly, I'm not sure yet - that's part of why I'm applying

Type option 4

11

How do you handle honest feedback, even when it's hard to hear?* This field is required.

12

This is a private, paid advisory program with three tiers. Are you in a position to invest in yourself at this level right now?* This field is required.

Yes, I'm ready to invest at the right tier

I'd like to understand pricing before I can answer that

I'm exploring this for the future, not necessarily right now.

Type option 4

13

Is there anything else you'd like me to know before we talk?