Free Relationship Consultation Questionnaire

Please fill out the information below to help us better prepare for our call together.

Once you complete your questionnaire, you will be directed to Michelle's calendar where you can book your FREE relationship consulation call.

Name

Phone Number

What is your relationship status?

Married or in a long-term relationship, living in the same home.

Married or in a long-term relationship, experiencing in-house separation.

Married or in a long-term relationship, separated and living in different homes.

Divorced, or divorce has been filed.

Dating, newer relationship.

Dating, and it is getting serious (or I want it to).

Single, and want to be in a long-term relationship.

Single, and interest in relationship coaching for myself and my future.

If you had a magic wand, what 3 words best describe your vision for your relationship?

What is getting in the way of having everything you envision for your relationship?

How committed are you to fixing this?

I am ALL IN! 10 out of 10!

I am committed, but I am afraid it is too late.

I am on the fence.

I am not sure.

1:1 Relationship Coaching is an investment in time and money. Are you willing to invest in yourself right now?

Yes. I am ready and willing.

No. I am not ready at this time.

Yes, but my resources are limited.

Get started today before this once in a lifetime opportunity expires.