Discovery Form: Complete your application to determine your best path

Allowing yourself to be supported is COURAGE. 
In the following questionnaire, take this as a chance for self-reflection and answer as truthfully and as specifically as you can.
Take 5-7mins to fill up this simple form so we can evaluate if we would be a right fit for each other. 
If we are a right fit - let’s explore more.
If we are not a right fit - we’d also let you know the reason so we can skip a virtual meet up to save each other’s time.
What's your first name?*
And your last name?*
What is your mobile number?*
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What best describe your couple relationship now?*
How many years are you married/ dating? (If Single, put "None")*
If you were to know, what blindspot(s) do you have that is/are affecting you? *
Are you willing to work on these blind spots if you are being shown how?*
What is your ideal life like?*
If you have a magic wand, what is one challenge of yours that you want to urgently transform to turn things around?*
How is this area of challenge affecting you right now? List at least 3 experiences.*
How is this costing you? (eg: Business/financial loss, divorce, depression etc)*
For how long has this been affecting you? (Eg: Years, Months, Days)*
How willing are you to do whatever it takes to change right now if you are being supported professionally? 10 for 100% willing and ready! (select a number)*
How ready are you to take action on winning back your marriage?*
Why do you choose Christine to support you? :)*
Lastly, will you be attending your discovery call as 1 pax or a couple?*
For Couples, what is your partner's name? (If you are coming as 1 pax, type NA).*
Ensure your partner submits their Discovery Form too!
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