* 1. Describe your #1 biggest challenge in relationship right now. Please be as detailed and specific as possible. Try to go beyond just saying "stop fighting" or "start having sex again". The more specific and detailed you are, the more likely we'll be able to cover your topic. For Example: "I feel like we can't get out of this pattern of bickering and negativity. No matter what I try, we can’t stop and we end up irritated, distant and living more and more separate lives."

* 2. Which of the following best describes you?

* 3. Which of these common challenges and hurdles are you experiencing in your relationship right now? (Check all that apply)

* 4. Which of these skills do you wish you knew more about?

* 5. How many hours per week do you currently...

* 6. Describe how you want your relationship to shift? Do not describe the problem, describe how you WANT it to be. Shift into what? What would it look like if you succeeded in making that shift? What would indicate the challenge had been resolved?

* 7. What do you think are the best solutions or pathways to make your last answer a reality?

* 8. What product formats seem like they would have the greatest IMPACT / best OUTCOME for your relationship? Check all that apply.

* 9. What product formats seem APPEALING to you to participate in? Check all that apply.

* 10. Lastly I may follow-up with a few people personally to learn more about your situation.  If you'd be open to talking with me for a few minutes, on the condition that I PROMISE I won't try to sell you anything, please leave your contact info below so I can reach you.

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