The Relationship Blueprint Assessment

Answer A Few Quick Questions To See If You QualifyFor A FREE Relationship Blueprint Call

Answer a few quick questions to see
if you qualify for a FREE Relationship Blueprint Call

Which of the following best describes your current relationship status? *

Single and dating, but nothing is fully sticking

Single and healing from something that broke my heart

In a relationship, but I don’t feel fully chosen

Married or long-term committed, but it feels unfulfilled

Recently separated or divorced

I haven’t dated seriously in a long time

What’s your primary motivation for transforming your love life? *

I want to experience real, lasting partnership

I’m tired of repeating the same painful patterns

I want to feel safe, chosen, and deeply loved

I know I deserve more, and I’m ready to receive it

Which of the following best describes your past dating experiences? (Check all that apply) *

I attract emotionally unavailable or avoidant partners

I fall hard and fast, then get hurt

I feel anxious or insecure once I start liking someone

I constantly feel like I’m the one chasing or proving myself

None of these describe me

Which of these patterns do you feel has held you back in love? (Pick the one that feels most true right now) *

Fear of abandonment or being “not enough”

Attracting the wrong types of men

Struggling to express my needs without pushing him away

Not knowing where to find a good man

I’m not sure. I just know something’s off

Please tell us more about your current love life situation. What's really going on for you right now? What feels stuck, is missing, or challenging? *

Have you ever worked with a relationship coach, therapist, or done personal development work? *

Yes, consistently (therapy, coaching, structured support)

Yes, occasionally (events, retreats, programs)

Mostly through books, podcasts, and self-study

Not yet, but I’m open

No, and I'm not open to it

How does travel currently show up in your life? (We host retreats and intimate experiences in Bali, Europe, and USA... so it helps us understand the rhythm of your lifestyle and how travel fits into it.) *

I travel often for work or pleasure and value freedom

I travel occasionally but life just feels too busy

I’m mostly home-based and rooted

I’d love to travel more, but finances make it difficult at the moment

Tell us a little about what you do professionally and what your typical week looks like. (This helps us understand how love can fit naturally into your life.)

Roughly, which range best reflects your current annual income? (So we can recommend a strategy that fits your lifestyle and level of responsibility.) * *

$200,000+ USD

$100,000–$200,000 USD

$60,000–$100,000 USD

$30,000–$60,000 USD

$0–$30,000 USD

If we identify a clear path that feels aligned for you, would you be prepared to invest in yourself to create the love life you truly deserve?

Yes, I’m ready to invest in my transformation

Yes, I'm willing to get creative with financing options if it feels like the right solution for me

I'm not open to a financial commitment at this time

What level of investment feels aligned for the transformation you're seeking through coaching, retreats, or bespoke 1:1 mentoring? *

$10,000 to $20,000 USD

$5,000 to $10,000 USD

$3,000 to $5,000 USD

I'm not in a financial position to invest right now

What's your name? *

Where are you based? *

What is your age? *

18-24

25-34

35-44

45-54

55-64

65+

What's the best email for us to contact you for your Relationship Blueprint Assessment? *

What's the best number to send you text updates about your application? *

By submitting this application, I give Haert2Heart permission to contact me by phone, SMS, or email about my Relationship Blueprint Assessment and potential next steps.

Yes, I agree to the terms and conditions.

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