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Worksheet

Enquire about a private transformational retreat

Please fill out the form below to enquire about booking a private retreat with Chalisa Morrison; customised to your unique needs.

My 5 star beautiful retreat setting is located in Torquay, on Victoria's picturesque Surfcoast on the iconic Great Ocean Road.  My acre property provides all that you need to connect in nature for a value packed transformational journey including a sauna, outside fire, hot tub as well as abundant resting places to integrate in beautiful gardens or under the Bali Hut. 

I offer a limited number of private retreats each year. Know that I do read each application carefully, and I personally reply to everyone who takes the time to complete my online form. I only take on a certain number of clients at any given time to ensure that I can provide a high level of comprehensive support to those individuals or couples I work with.  If I can't support you immediately, that doesn't mean that I won't be able to support you in the future.

Please know that your privacy is important to me and I will treat your confidential information with great care and respect.

Thanks for your patience and I look forward to supporting you.

Kindness and respect,

Chalisa


1. ➜

Date

2. ➜

Name

3. ➜

Email

4. ➜

Phone

5. ➜

Please tick whether you are applying as an individual or couple

6. ➜

Partner's name - if applying as couple

7. ➜

Partner's email - if applying as couple

8. ➜

Please confirm what you are most interested in?

9. ➜

Please tick that you understand:

10. ➜

What kind of retreat are you looking for?

Everyone has different needs and preferences; Chalisa has a private retreat space where she runs private retreats and runs groups retreats in Bali.

-> Some people prefer a softer style retreat where they have 1 transformational session a day with more time to do as they please and other people prefer a more structured approach with more therapy sessions to create transformation and support change

 

11. ➜

Tick the relevant areas that best match what you are looking for:

12. ➜

Which style of private retreat are you most interested in?

13. ➜

Please tick your preferred retreat option

14. ➜

When is your ideal timing to book in a private weekend retreat with Chalisa?

Share any thoughts you may have, including several options over the next few months that you're available:

15. ➜

Please describe your top 5 challenges that you're currently experiencing:

16. ➜

If you were to work with Chalisa during a transformaitonal retreat, what would be an amazing outcome?

17. ➜

Have you completed any of Chalisa's online 'Love Me Up' programs?

18. ➜

Have you previously worked with Chalisa in private 1:1 sessions?

If you have previously worked with Chalisa, please advise: when you worked with me, approximately how many sessions and briefly what was most beneficial to you (or your relationship):


19. ➜

If you have ticked 'yes' above, please tick which online programs you have completed / started:

20. ➜

Are you willing to:

21. ➜

How would you like your food to be catered for?

Everyone has different food preferences. 

-> The retreat space has a fridge, microwave, kettle, toaster and sandwhich press

22. ➜

Can you afford to attend a private retreat with Chalisa?

As an example, the investment for Chalisa's popular 'Save My Marriage' weekend couples retreat costs $5995 per couple (includes all sessions, gourmet meals, 2 nights/3 days luxury accommodation and extra's).  Extra therapy sessions can be arranged at $250 p/hr


23. ➜

How much notice do you need before being able to attend a weekend retreat with Chalisa ?

Please also include where you are located

24. ➜

Are you a student, unemployed or on sickness leave?

25. ➜

Is their anything else you want to say or want me to know?

26. ➜

What is your preferred way to be contacted?

27. ➜

We would love to hear about how you heard about Chalisa and her work (if you can spare the time)