Love Muffin Application

Complete this form so I can get to know you better.

Name*

First NameLast Name

E-mail*

Phone Number*

Area CodePhone Number

Are you interested in getting in a committed relationship/engaged in the next 6-12 months?*

YesNot Sure

LoveMuffin supports women in all 3 stages of relationship, which stage are you in now?

Phase 1: Relationship Readiness- I am not dating yet or I am dating and I don't like it.Phase 2: Feeling excited to date but am not sure how to do it or where to go to find quality partners.Phase 3: In a new relationship and I want to make sure it stays healthy and happy.I am not sure.

What are your biggest obstacles in finding and keeping love right now? *

What do you think is in the way of you having the relationship you want? *

Why do you want a relationship right now? *

What other areas of your life do you imagine will improve as a result of having a loving partner cheering you on in life? (health, wealth, productive at work, happiness)*

What have you tried so far? (classes, therapy, coaching, online dating)*

On a scale of 1-10 - How committed are you to learning what it takes to find love?*

If you are not a 10, describe what is in between your number and 10.*

What about Love Coach Macy (AKA Rev Lunchlady) attracted you to reach out?*

If we see that coaching would be valuable for you to reach your relationship goals and decide we are a fit to work together, are you able to joyfully invest in my help?

YesNot SureNoI don't invest in myself

You're done! Thanks for sharing! Click below to submit your form and on the next screen you will receive a link to book a time on my calendar! I look forward to meeting YOU.