You are applying to be a client in the H.E.R Way Relationship Intensive by Bernadette Jackson. Please fill out the application below.

If you’re a good fit, we’ll invite you to a private call to learn more about how we can help you craft your unique relationship recipe. 


Please be as detailed as possible in your responses so we can have an accurate picture of where you are now.

  • Step 1
  • Step 2

Basic Info

Full Name

Email address


What is your father loss type?

What is your relationship status?

Getting to know you

What is your biggest relationship struggle and why do you believe the H.E.R Way Relationship Intensive will help you be successful?

Envision an amazing relationship. What does it look like?

What have you done in the last 6 months to bring you closer to your vision for an amazing relationship?