Love Breakthrough Session Application

“Vickie is a coach with heart and soul, and I will be forever grateful for her and her work. She is compassionate and caring.”
– Heike B., Chatsworth, CA

 




    1. What is your profession?


    2. What is your age?

    3. What do you most want to change about your experience of dating/relationships?

    4. On a scale of 1-10, how motivated are you to make the changes that you listed in the previous question?

    5. Have you worked with a therapist or coach in the past? I so, what was your experience?

    6. On a scale of 1-10, how ready are you to invest in changing your relationship patterns?

    7. What else do I need to know about you to support you in reaching your goals?