JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Relationship Shaman
Use this form to provide a little bit of information for me in order to determine whether this program is a great fit for you and your desired outcomes within your relationship.
* Indicates required question
Email
*
Your email
Name (First Last):
*
Your answer
What type of relationship are you interested in working on?
*
With Self
With a partner (i.e. romantic relationship)
With a business relationship (i.e. partner, employee, manager, boss)
With a family member (i.e. parent, sibling, child)
Other:
Why are you interested in beginning this program?
*
Your answer
Is the other person that you want to improve your relationship with interested in doing this work with you?
*
Yes
No
N/A (choose for Self relationship work)
What areas of your relationship do you feel you want to improve?
*
Your answer
What areas of your relationship do you already feel great about?
*
Your answer
How will doing this work impact your life moving forward?
*
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Solstice Yoga.
Report Abuse
Forms
