PLEASE FILL OUT THE INFORMATION LISTED BELOW

Thank you for taking the Life Balance Estimator - Fifty-five hours is the default hours per week used, although the Intimate Communication Specialist can change the hours as needed. These numbers should be consistent.  In order for the formula to work properly the total percentage should be equal to 100 in each section when entering the scores on the web based application sheet below. If you have any questions please feel free to contact us. Thank you! Tell us how to get in touch with you: Name of Intimate Communication Specialist Required Field E-mail Required Field Tel Required Field Fax Address City State Zip Code Number of Hours Utilized Intimate Communication Specialist Partner 1, Self Partner, Self Immediate Family Extended Family, Partner 1 Extended Family, Partner 2 Social, Partner 1 Social, Partner 2 Partner 1 - Actual Time Spent Self Partner Immediate Family Extended Family, Partner 1 Extended Family, Partner 2 Social, Partner 1 Social, Partner 2 Partner 1 - Actual Time Wanted Self Partner Immediate Family Extended Family, Partner 1 Extended Family, Partner 2 Social, Partner 1 Social, Partner 2 Partner 2 - Actual Time Spent Self Partner Immediate Family Extended Family, Partner 1 Extended Family, Partner 2 Social, Partner 1 Social, Partner 2 Partner 2 - Actual Time Wanted Self Partner Immediate Family Extended Family, Partner 1 Extended Family, Partner 2 Social, Partner 1 Social, Partner 2 Please submit any questions or comments you might have: Would you like to be contacted for a consultation?