Initial Retreat Application

Name: *

Email: *

Phone *

What do you want to get out of a retreat with me? *

What are your challenges in having that now? *

What have you tried to address those challenges? How did that work for you? *

What is it costing you to have these challenges? *

What do you want instead? What is your vision? *

What would life be like if you were able to have that? *

How committed are you to achieving your vision? *

Not very committed

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Very committed