Heal Your Relationship With Money Course Interest Form

Thank you for your interest in our Heal Your Relationship With Money Course! The next course begins  September 27, 2022!

Heal Your Relationship With Money And Become Financially Free is designed for people who were never taught to care about personal finance and feel completely overwhelmed, anxious, and in chronic stress when it comes to money. This course will teach you how to get out of debt and build wealth so you can become financially independent and harness your innate power to take control over your destiny and build a brighter future.

Are you ready?
Apply here
(5-10 minutes to complete)


Question 1 of 20

First Name

Question 2 of 20

Last Name

Question 3 of 20

Email Address

Question 4 of 20

Phone Number

Question 5 of 20


Question 6 of 20


Question 7 of 20

Profession (List all that apply)

Question 8 of 20


Question 9 of 20

What are 3 things holding you back from being financially free? What hurdles are you running into? Tell me everything. :)

Question 10 of 20

Where are you with debt and savings? The more details the better!


Question 11 of 20

What challenges are you working through right now?

Question 12 of 20

What have you tried so far to help you take control over your finances?

Question 13 of 20

What causes you the biggest stress or anxiety? How is everything affecting you?

Question 14 of 20

Take a moment and daydream for a minute...One year from today, what does your life look like? What's your ideal?

Question 15 of 20

What is your number one goal and result you want more than anything else?

Question 16 of 20

What do you think has been holding you back from achieving your goal?

Question 17 of 20

What would it mean for you to achieve that goal? How would it change your life?

Question 18 of 20

Are you ready to get this result right?






I can wait


I wanted to start yesterday!!

Question 19 of 20

Working with us is a big investment of time, money and energy. Our program is intensive and deep. Are you in a position to make the investment of time, money and energy?


I'm SO ready!


I'm not sure

Question 20 of 20

How did you hear about us?

Confirm and Submit