Private Mentoring for Couples

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Full Name

Phone Number

Country

Post Code / Zip Code

Age

1. How long have you been in your current relationship?

2. What prompted you to want to work with Janet?

3. What other counselling or coaching work have you done before?

4. What is it you desire most in your life right now?

5. What’s working in your life/relationship right now?

6. What are the physical or emotional issues?

7. Is there anything else you’d like me to know?