Coaching Request Form

Coaching Request Form

If you are interested in working 1-on-1 with Alex or one of the certified HTM coaches, please fill out the form below. The fields marked with the red asterisk are required, but the more you fill in the better we can determine if you are a good match for coaching.

Email Address*
Name*
Phone
What is your current priority that you'd like support with*
Dating/Starting a relationship
More and better sex in my single life
More and better sex in my relationship/marriage
Re-ignite a stalled relationship or marriage
Take a good or great marriage to the next level
Work on my own personal transformation and alignment / Level up as a man
Other
What is the number 1 thing you feel has held you back from reaching this goal?*
How long have you been working towards this?*
1-3 months
3-12 months
12-24 months
3+ years
Feels like forever
How much have you already invested in this goal?
Less than $1000
$1000 - $5000
More than $5000
I have not invested yet in solving this issue
What does full success look like to you?
What is your level of urgency to get on track with this issue?*
It's important, but I've been living with it for a long time, and it is not urgent
Urgent. Getting on track is a high priority for me this year
This is my top priority and I need to get moving immediately to keep my life from breaking down in a significant way
Is there anything else you need me to know in evaluating whether to consider you as a client?
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