Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Relational Longevity Couples Intensive Application
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Names of both partners
*
Your answer
Both emails:
*
Your answer
Best cell:
*
Option 1
What has you interested in an intensive with me? Describe briefly your situation and what you're looking for.
*
Your answer
What have you tried that helped or didn't help?
*
Your answer
Are you able to fly to Boulder, Colorado and spend up to three 4-hour days with me in person, with possibly some follow up zoom sessions?
Yes
No
Other:
Clear selection
Are you interested in information on intensives that are facilitated by both my husband, Jayson Gaddis, and I together?
Yes
No
Clear selection
Are you interested in having me travel to you and facilitating the intensive in your home? (Additional expense)
Yes
No
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report