Create Healthy Boundaries Market Research

Once you complete and submit this form, you will be given instructions on how to request your free copy of the Create Healthy Boundaries Guide.

1. Which family member are you having the most difficulty with?*
- Mother
- Father
- Significant Other
- Adult Child
- Sibling
- In-Laws
- Other Family Member
2. What are the biggest challenges you’re facing with this person? (check all that apply)*
- He/She often misunderstands me.
- I'm afraid to say anything that might lead to conflict.
- He/She judges me and/or my choices.
- He/She is controlling.
- I feel guilty saying NO to him/her.
- He/She is manipulative.
- I don't want to disappoint him/her.
- He/She doesn't listen very well.
- He/She never takes responsibility for anything.
Other Challenges? (optional)
3. Of the all of the challenges you checked off or mentioned above, which one would you say is the biggest priority for you to solve now?*
4. How do these challenges make you feel? (check all that apply)*
- I feel unsupported.
- I feel alone.
- I feel "not good enough."
- I feel disrespected.
- I feel angry.
- I feel excluded.
- I feel disappointed.
- I feel invalidated.
- I feel rejected.
- I feel unloved.
Any other feelings or negative impact on your life? (optional)
5. List all the words/phrases/questions that you would type if you were to do a Google Search to find solutions to your current challenges.*
6. If you were granted a wish to change your relationship with this person, what would you ask for?*
7. If your wish came true, what would that do for you?*
8. On a scale of 1 to 10 (10 being the highest), how serious are you about solving your current challenges?*
1 2 3 4 5 6 7 8 9 10
9. If I could create a program to help you solve your family challenges, which topics below would you like to see included? (check all that apply)*
- Select All
- how to deal with guilt & shame
- how to create healthy boundaries
- how to let go of pain and heal past wounds
- how to not get sucked into an argument or drama
- how to deal with a narcissist
- how to be authentic and loving in the midst of hurt and anger
- strategies to use when conflict arises
- understand negative family dynamics it's impact on my relationships
- how to rebuild a relationship that's broken down
- how to stand in my power and not get knocked down when others become confrontational
- how to deal with fear of being judged, rejected or abandoned by my family if I speak my truth
Are there any other topics you are interested in learning more about that are not listed above? (optional)
10. If I were to run this as a pilot, where I took on a smaller number of clients, and you were to get more access to me, would that be of interest to you?*
If you checked YES above, make sure to fill in your name and email address below so I can notify you when the program is ready.
Name
First Last
Email