Self-Love Activation Call Application
Please know that while it is Melissa's desire to help as many women as possible learn how to choose themselves and create the life and relationships they most desire, that we are very selective in finding a right fit and do not accept all applications---Please take your time to fill out this form fully. If it is clear that Melissa can help, she will reach out and schedule a call with you to connect more deeply with your desires, your strengths and your blocks and lay out a plan for how you can most powerfully transform and cultivate a loving relationship with yourself over the coming months.
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Email *
Name: *
Email: *
Phone Number: *
Age: *
Relationship Status: *
What do you do for a living? (If your job doesn't reflect your true passion, feel free to share about that, too.) *
How did you hear about Melissa? *
What is calling you to work with a Self-Love & Relationship Coach at this time? What is not working so well in your life & relationships and what is the true impact of that? (The more details the better.) *
What results do you want to create through working with Melissa? (Again, the more details the better.) *
Are you currently enrolled in any other coaching or therapy programs? *
If you answered YES to the above question, what are you currently enrolled in?
If you've worked with a coach or therapist in the past or present, tell me what you liked and didn't like.
On a scale of 1-10, how motivated are you to make changes in your life & relationships? 10=most? *
On a scale of 1 to 10 (10=most), how secure do you feel financially? (Coaching is an emotional and financial investment in yourself) *
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