Author & Coach

Cheryl
Johnson

Application For Soul Makeover Program

First name

Last name

Email

Phone

Are you married? And if so, how long have you been married?

Do you have children? If yes, how many and what are their ages?

On a scale of 1-10 (1 being in crisis, 10 being thriving), how would you rate your marriage right now?

What are the top 3 challenges you're currently facing in your marriage?

Have you and your spouse discussed your marriage struggles together? If yes, what was the outcome?

Is your husband aware that you're applying for this program?

Yes, and he's supportive

Yes, but he's hesitant

No, I haven't told him yet

Other

Do you believe past trauma (childhood, previous relationships, etc.) is affecting your marriage today? Please explain.

What emotional patterns do you notice repeating in your relationship? (Examples: defensiveness, shutting down, anger outbursts, withdrawal, etc.)

Have you worked with a therapist, counselor, or coach before? If yes, what was your experience?

Are you currently in therapy or receiving any mental health treatment?

Yes

No

Not currently, but I have in the past

Do you find yourself blaming your spouse for problems in your marriage more often than taking responsibility for your own part? Please be honest.

Yes

No

What unrealistic expectations do you think you might be placing on your husband or your marriage?

How do you typically respond when your husband doesn't meet your expectations?

On a scale of 1-10, how would you rate your self-esteem and confidence right now?

How would you describe your current communication with your husband?

When was the last time you felt truly connected to your husband emotionally? What was happening?

How do you typically express your emotions to your husband?

On a scale of 1-10, how satisfied are you with the level of intimacy (emotional and physical) in your marriage?

Why do you want to join Soul Makeover right now? What's driving you to seek help?

What do you hope to achieve by completing this program? What would success look like for you?

Are you willing to do the inner work required for transformation, even when it's uncomfortable?

Absolutely, I'm ready

Yes, but I'm nervous

I'm not sure

I need more information

Are you financially prepared to invest $3,000 in this program?

Yes, I'm ready to enroll

Yes, but I need a payment plan

I need more information about pricing

Not at this time

By submitting this application, I acknowledge that: (1) I have answered all questions honestly, (2) I understand that Soul Makeover requires personal commitment and inner work, (3)I am open to transformation. Signature Below:

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Author & Coach

Cheryl
Johnson

Media

Author & Coach

Cheryl Johnson

Application For Soul Makeover Program

Author & Coach

Cheryl Johnson

Cheryl
Johnson

Cheryl
Johnson