Enquiry Form - Couples Intimacy Retreat

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Enquiry Form - Couples Intimacy Retreat - Majorca 2023

Please take a moment to tell us more about you and your relationship. We ask you these questions to build a picture up of your relationship and what needs you may have, to tailor certain aspect of the retreat to you both. Once completed we will endeavour to come back to you with next steps.

If your answers differ between you, you may wish to fill out the form separately and send in. We will accept both.

Email *

Presented to you by the Love University

First and Last Name of You *

First and Last Name of Your Partner *

Your Home Address *

Best Contact Number for you both *

How long have you been with your partner? *

Do you have any children from current or past relationships, if so how many? And what ages are they? *

What do you hope to gain from attending this retreat? *

What are you looking to improve in your relationship? *

Communication

Intimacy

Connection

Sex Life

Fun/ Spontaneity/ Variety

Other:

Required

What things have you tried to improve your relationship, if applicable? *

Counselling (in the last 12 months)

Counselling (longer than 12 months ago)

Workshops (specifically for helping couples)

Couples Retreats

Self Help Books (Read in the last 12 months)

Nothing to date

Other:

Required

Anything else you wish to tell us?

Where did you hear about us? *

Thank you for taking the time to fill this in, we shall be in touch.

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