Relationship Rescue Coaching Program | Application Questions

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Name *

First

Last

Email *

Phone *

What is your relationship status? *

What motivated you to seek relationship coaching? *

What do you believe about yourself and your worth? *

What are the relationship patterns you would like to change? *

What experiences have shaped you into the person you are today? *

What else can you share about that experience that made it so challenging for you? *

What is most important to you in your relationship with yourself and others? *

What is preventing you from reaching your goal? *

Finish the statement below: Right now I… *

Finish this statement, too: if someone suggests I enroll in the Relationship Rescue Coaching course, I would… *

Do you promise to show up for your scheduled appointment On TIME and DISTRACTION FREE? Please confirm by typing “Yes, I will” in the box below. *

Finally, on a scale of 1 to the moon, how majestic are you, XXX?

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Email *

Jacqueline Audigé
(301) 478-4948
info@jalifecoaching.com