HEALTHY-LOVE
IS WITHIN REACH
Complete the form below to start your journey to a healthier relationship.
Name
Email
What's your relationship status?
Committed relationship
Engaged
Married
Separated
Single
What's your partner's name? (if applying for Couples Coaching)
What is the biggest challenge you’re facing in your relationship right now?
What efforts have you attempted to address your relationship issues (e.g., therapy, coaching, etc.)? Were they effective?
How would you describe your partner's level of willingness to work on the relationship?
My partner is open and willing to work on things with me.
My partner is hesitant but willing to listen.
My partner avoids or resists working on the relationship.
I feel like I’m the only one trying.
On a scale of 1-10, how emotionally connected do you feel to your partner? (1 = Not connected, 10 = Deeply connected)
Do you feel seen, heard, and understood by your partner?
Yes, most of the time.
Sometimes, but not consistently.
No, I often feel misunderstood or unheard.
If you could change ONE thing in your relationship today, what would it be?
What do you feel would make your relationship healthier and more fulfilling?
What do you hope to achieve through coaching? (Check all that apply)
Improve communication
Rebuild trust and connection
Gain clarity on what I need in a relationship
Strengthen emotional and physical intimacy
Resolve ongoing conflicts
Learn how to manage my emotions
Improve self-awareness and emotional intelligence
On a scale of 1-10, how committed are you to making positive changes in your relationship?
Are you ready to invest in your personal growth and relationship transformation? (Sessions start at $200 per session, with tailored packages available.)
Yes, I’m ready to invest in myself and my relationship.
I’m interested, but I have questions about the investment.
I’m not sure if I’m ready to invest at this time.
If your application is approved, you will receive a private invitation to book a Relationship Reset Call ($50, applied to coaching if booked within 10 days). Are you open to this next step?
Yes, I want to gain clarity and take the next step.
No. I don't need the Rest Call, I am ready to commit to coaching.
No, I am only looking for free resources at this time.
Apply Now
Complete the form below to start your journey to a healthier relationship.
Name
Email
What's your relationship status?
Committed relationship
Engaged
Married
Separated
Single
What's your partner's name? (if applying for Couples Coaching)
What is the biggest challenge you’re facing in your relationship right now?
What efforts have you attempted to address your relationship issues (e.g., therapy, coaching, etc.)? Were they effective?
How would you describe your partner's level of willingness to work on the relationship?
My partner is open and willing to work on things with me.
My partner is hesitant but willing to listen.
My partner avoids or resists working on the relationship.
I feel like I’m the only one trying.
On a scale of 1-10, how emotionally connected do you feel to your partner? (1 = Not connected, 10 = Deeply connected)
Do you feel seen, heard, and understood by your partner?
Yes, most of the time.
Sometimes, but not consistently.
No, I often feel misunderstood or unheard.
If you could change ONE thing in your relationship today, what would it be?
What do you feel would make your relationship healthier and more fulfilling?
What do you hope to achieve through coaching? (Check all that apply)
Improve communication
Rebuild trust and connection
Gain clarity on what I need in a relationship
Strengthen emotional and physical intimacy
Resolve ongoing conflicts
Learn how to manage my emotions
Improve self-awareness and emotional intelligence
On a scale of 1-10, how committed are you to making positive changes in your relationship?
Are you ready to invest in your personal growth and relationship transformation? (Sessions start at $200 per session, with tailored packages available.)
Yes, I’m ready to invest in myself and my relationship.
I’m interested, but I have questions about the investment.
I’m not sure if I’m ready to invest at this time.
If your application is approved, you will receive a private invitation to book a Relationship Reset Call ($50, applied to coaching if booked within 10 days). Are you open to this next step?
Yes, I want to gain clarity and take the next step.
No. I don't need the Rest Call, I am ready to commit to coaching.
No, I am only looking for free resources at this time.
Apply Now
