Hold Me Tight Workshop - September 20

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Hold Me Tight Workshop - September 20 - 21, 2025

We are so happy that you have taken this step for your relationship. The three of us are looking forward to our time together. Please fill out the following information. If you have any questions please email anna@cozychaircounseling.com.

Partner 1 - Name (first and last)

Partner 1 - Email Address *

Partner 1 - Telephone Number *

Partner 1 - Mailing Address (please include city, state, & zip code)
*

Partner 2 - Name (first and last)
*

Partner 2 - Email Address *

Partner 2 - Telephone Number *

Does Partner 2 have the same mailing address? *

Yes (continue to multiple choice questions below)

Required

Partner 2 - Mailing Address (please include city, state, & zip code)

If you are coming with another couple please let us know who will be joining you.

How solid is your relationship? *

We are solid, we just want to feel closer

Occasional distress, strong commitment

We’ve been struggling a lot

High distress, we are in trouble

Are you currently in therapy? *

Yes, couples therapy

Yes, Partner 1 attends individual therapy.

Yes, Partner 2 attends individual therapy

Is there anything else you want us to know about your relationship in advance of this workshop?

Submit

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