Name
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First Name
Last Name
Email
*
Phone
(###)
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Service You’re Interested In:
How long have you been married?
What challenges are you currently facing in your marriage? (e.g., communication, trust, finances, intimacy, etc.)
Have you tried any other forms of mediation, counseling, or therapy before? If yes, please explain.
What are your primary goals for this mediation session?
Are both parties committed to the process of mediation?
How would you describe your current spiritual journey as a couple?
Do you have children? If so, how has the current situation impacted them?
Any other concerns or details you’d like us to know before your session?
How long have you been engaged or dating?
Do you have a wedding date set? If so, when?
Have either of you been married before?
What are the top three areas you’d like to focus on during premarital counseling? (e.g., communication, finances, spiritual alignment, conflict resolution, etc.)
How would you describe your current relationship with God, individually and as a couple?
Are there any specific concerns or topics you’d like us to address in the counseling sessions?
Do you both agree on the importance of faith and spirituality in your future marriage?
Any other details you’d like us to know before your counseling begins?
