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Worksheet

Private Couples Retreat Enquiry — Let’s Explore What Support Might Help Your Relationship

Please complete the form below to enquire about a private couples retreat with Chalisa Morrison. Each retreat is thoughtfully customised to support your unique relationship and the changes you are hoping to create together.

If you’re unsure where to begin, you’re also welcome to start by booking a complimentary clarity call instead.

My beautiful 5-star retreat setting is located in Torquay on Victoria’s picturesque Surf Coast along the iconic Great Ocean Road. The one-acre property offers a peaceful space to slow down, reconnect with nature, and focus fully on your relationship. Facilities include a sauna, outdoor fire, hot tub, and many quiet places to rest, reflect, and integrate within the gardens or beneath the Bali Hut.

I offer a limited number of private retreats each year so that I can provide deeply personalised support. I personally read every enquiry and reply to everyone who takes the time to complete this form. If I’m not able to support you immediately, that doesn’t necessarily mean we won’t be able to work together in the future.

Your privacy is very important to me, and any information you share will be treated with care and complete confidentiality.

Thank you for taking this step.

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. ➜

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

10. ➜

What kind of private 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. ➜

Which style of private retreat are you most interested in?

12. ➜

Please tick your preferred retreat option

13. ➜

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

14. ➜

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

15. ➜

Parter 1 - On a scale from 1–10, how committed do you currently feel to working on your relationship?

Relationships go through difficult seasons. At this moment, how committed do you each feel to working on the relationship?

16. ➜

Parter 2- On a scale from 1–10, how committed do you currently feel to working on your relationship?

Relationships go through difficult seasons. At this moment, how committed do you each feel to working on the relationship?

17. ➜

What gives you hope for this relationship?

18. ➜

If this retreat helps your relationship move in the direction you’re hoping for, what would that mean for your life together?

19. ➜

Are you willing to:

20. ➜

Can you commit to the costs of Chalisa's private retreats?

As an example, the investment for Chalisa's popular 'Save My Marriage' weekend couples retreat is $6997 per couple (includes all sessions, gourmet meals, 2 nights/3 days luxury accommodation and many extra's - valued at $9022). The investment for the Couples Getaway Retreat is $5297 (valued at $6734). Retreats are customised for each couples' needs.


21. ➜

Have either of you previously worked with Chalisa or participated in a Love Me Up program?

22. ➜

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:

23. ➜

If we feel that a retreat is the right support for your relationship, how ready are you to move forward?

24. ➜

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

Please also include where you are located

25. ➜

If we both feel a retreat is the right support for your relationship, what might prevent you from moving forward?

26. ➜

How would you like your food to be catered for at your retreat?

Everyone has different food preferences. 

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

27. ➜

What is your preferred way to be contacted?

28. ➜

Is there anything important you would like me to know before we speak?

29. ➜

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

30. ➜

Thank you for sharing a little about your relationship — I read every inquiry personally.

31. ➜

What happens next


After submitting this form, Chalisa will personally review your inquiry.

If it feels like a private retreat could support your relationship, the next step is a complimentary 20-minute Clarity Call where we can briefly talk about what is happening in your relationship and explore whether a retreat would be the right fit for you both.

You’re also welcome to book a Clarity Call now if you would prefer to speak sooner.
Book a Clarity Call