Application - Relationship Resilience Group
It’s important to make sure that you and the group are a great fit for each other. There are two levels to discern that. (1) All prospects fill out an initial application. Then I'll call and we'll schedule a 20 minute meeting. (2) If the group is already full, we'll add you to the waiting list. Or we'll talk through your options.
* Required
Email address
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Your email
Name
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First and last name
Your answer
Are you a current or previous client?
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Yes, I'm currently seeing you for counseling or consulting
Yes, I'm a previous client and have seen you in the past
No
Other:
What kind of support do you have now?
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Your answer
What would you like to get from being in the "Relationship Resilience" group?
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Support - I'm too isolated with all the changes I'm going through
I need help with doing the next right thing
I need skills and accountability i.e. assertiveness, confidence, communication
I need clarity and sense of purpose
All of the above
Other:
Required
What do you think transformation would look like for you after completing seven weeks of group experiences?
Your answer
What are the biggest obstacles you face with a seven-week commitment toward nurturing your true self?
Your answer
How crucial is this transformational opportunity for you now?
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I'm so unsure at this point.
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I'm whole-heartedly committed to taking risks of growth. This group is exactly what I need right now.
What draws you to the group at this time?
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Your answer
If you and I could sit down and visit with a cup of tea or coffee, what would you like to share?
Your answer
What is the best way to contact you? (please include phone number)
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Your answer
Send me a copy of my responses.
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