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Research

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Become a Member

If you are willing to answer some extra questions you will get 20 minutes free consultation instead of 10..

Please answer as many as possible
Enter N/A or none if not applicable

About You

1

Your approximate annual income

How often do you travel each year

Please answer as many as possible

Enter N/A or none if not applicable

2

Current Relationship Challenges

Your current relationship status

If Other, please describe here

Briefly describe your dating history? (e.g., single for a while, recently divorced, casually dating)

What methods have you tried for dating

If Other, please describe here

What could make dating feel less frustrating and more meaningful?

Please answer as many as possible

Enter N/A or none if not applicable

3

Retreat Preferences

Have you attended a retreat before

If Yes, what type of retreat

What was your experience like

What are your ideal preferences

Cost

Personal time each day (8am and 10pm)

Duration

Location

Please answer as many as possible

Select one from each

4

Activity Interest - 1 (least interested) to 5 (most interested)

Sound Healing

1

2

3

4

5

Energy Work

Psychology Exercises

Ecstatic Dance

Tantra

Women's and Men's Circles

Yoga or Exercise

Ice Breaker Activities

Shibari

Breathwork

Free Time

Contact Improve

Boat Trip

Nature Work

Art Workshop

Please answer as many as possible

Select one from each

5

Party & Evening Entertainment - 1 (least interested) to 5 (most interested)

Live Music

1

2

3

4

5

Drag Queen Performance

Circus Performance

Burlesque Show

Amazing Food

Drumming circle

DJ Dance Party

Ecstatic Dance

Fire Show

Latin Dance

Keynote Motivational Talk

Please answer as many as possible

Pick one or more

6

Type of Retreat

Retreat Type Required

Please answer as many as possible

Enter N/A or none if not applicable

7

Key Factors for Signing Up

Do you think the event should require an intake call for participants

Please answer as many as possible

Enter N/A or none if not applicable

8

Food Preferences

General Diet Type

Prefered Cuisine Styles

Religious or Cultural

Medical or Allergen

Please answer as many as possible

Enter N/A or none if not applicable

9

Gift Bag Preferences

Would you like a gift bag at the retreat

Which would you be interested in

(Select all that apply) Required

Please answer as many as possible

Enter N/A or none if not applicable

10

Promotion and Awareness

How should this retreat be promoted

(Select all that apply) Required

Other methods you think would be effective

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© 2025 by Dr Helene Laurent-Oliver, D. CLin Psy. 

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