JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Return To Wholeness
Strategy session application and questions to support making the most of our precious time together. Your responses will be copied to your email and you are welcome to further reflect on them and change them at any time.
* Indicates required question
Email
*
Your email
Name (of both people if seeking couples coaching/mediation)
*
Your answer
Phone
*
Your answer
What are your biggest challenges when it comes to your relationships?
*
Your answer
What have you tried in your desire to resolve this challenge?
Your answer
On a scale of 1-10 how important is it for you to resolve this?
*
not really important
1
2
3
4
5
6
7
8
9
10
essential - this must change
What days and times work best for you. Please include your time zone.
If you are seeking couples coaching, it works best to have him/her/them join us for the entire session. In that case, please let me know what times could work for both of you.
*
Your answer
Thank you for choosing to take a step towards more love and less conflict. I will contact you in the next 48 hours with days and times which are available in my schedule.
Warmly,
Katrina Vaillancourt
CSE &
CNVC Certified Trainer & Mediator
With
over 25 years experience in spiritual and transformational modalities
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
