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Relationship Bonding Experience Form
Here is where your connection begins!
As a certified relationship coach, CBT, & metaphysician, I will reach out to you with a short response and see how I can help you and your partner deepen communication, build clarity, and strengthen your bond moving forward.
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* Indicates required question
What is your name?
*
Your answer
When is your birthday?
MM
/
DD
/
YYYY
What is the biggest struggle you are currently facing in your relationship?
Your answer
How is it making you feel?
Your answer
What do you want to improve or want to happen/change?
Your answer
How important is it to you to overcome this obstacle (from a scale of 1-10)?
I'd pay $50 worth to solve it
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10
i'd pay $5000 worth to solve it
Clear selection
Is there anything else you would like to share? What is going on in your life? How are you feeling?
Your answer
What is your email?
*
Your answer
What is your phone number?
Your answer
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