The Academy for Intimacy
Thank you for taking the time to fill in this quick questionaire. This is an opportunity for me to get to know a little bit more about you and see how we might fit together. I'll be in touch within 48 hours. Until then be well and thanks for being here.
Email address *
What is your full name *
Your answer
Contact phone number & best times to call *
Your answer
What is your desired outcome? *
Your answer
What is your biggest challenge in regards to your desired outcome? *
Your answer
What is it costing you (time, emotionally, professionally) to be in your current situation? *
Your answer
How committed do you feel to making changes to reach your desired outcome? *
ery low commitment
I'll do whatever it takes
Thank you! I'll be in touch soon to set-up your complimentary Discovery Call.
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