True Love Session

First Name*

Last Name*

Phone**

Email**

WHERE ARE YOU AT RIGHT NOW IN RELATIONSHIP?**

HOW SATISFIED ARE YOU WITH YOUR LOVE LIFE?*

WHAT IS YOUR BIGGEST CHALLENGE IN YOUR LOVE LIFE/DATING LIFE RIGHT NOW?**

WHAT HAVE YOU TRIED IN THE PAST TO IMPROVE YOUR LOVE LIFE/DATING LIFE?**

WHAT ARE YOU LOOKING FOR IN YOUR IDEAL RELATIONSHIP?**

WHEN DO YOU WANT TO BE IN AN EXTRAORDINARY, EPIC, LOVING PARTNERSHIP? **

3 months from now
6 months from now
1 Year from now

ON A SCALE OF 1 TO 10, WITH 10 BEING 100% COMMITTED, HOW COMMITTED ARE YOU TO FINDING LOVE?**

DO YOU HAVE OR WANT TO HAVE BABIES? **

Yes, I have kids
I'm actively trying to have a baby now or soon
I would love to have a baby in the next 5 years or so
No

ARE YOU READY TO HIRE A COACH AND INVEST YOUR FINANCIAL RESOURCES INTO TRANSFORMING YOUR LIFE?**

PLEASE COMMIT TO YOUR APPOINTMENT BY TYPING THIS SENTENCE IN THE BOX BELOW: "YES, I PROMISE I WILL CALL THE ZOOM LINE FOR MY BREAKTHROUGH SESSION AT MY BOOKED APPOINTMENT TIME :-)**

ON A SCALE OF 0 TO 10, HOW EXCITED ARE YOU TO TALK TO MIRA AND TO FINALLY FIND THE MAN OF YOUR DREAMS AND HAVE LASTING LOVE?*

True Love Session

Breakthrough Session Questionnaire