Marriage Coaching Information Form
This form communicates your options for coaching. Please complete all questions. Once your form is complete, you will receive confirmation and you will be asked to schedule your first visit, which will be 2 hours. All subsequent coaching sessions are for 1 hour each week. If you have any questions, please contact us at
Email address *
First and Last Name *
Spouse First and Last Name
Address including City, State, Zip Code
Best Contact Phone Number *
How many years have you been married? *
Will you attend the coaching sessions alone or with your spouse *
Which coaching package are you considering *
Are you interested in online or in person coaching sessions *
Which topic will be the primary focus for your sessions? *
Have you scheduled your 30 minute initial consultation? *
You understand that completing this form does not begin the coaching process. You understand that coaching will not begin until payment (or payment arrangements) have been completed. You understand that this covenant coaching relationship is confidential and can be terminated at any time by either client or coach. *
You understand that there is a $50 cancellation charge for all sessions that are canceled on the day of our scheduled meeting. The charge will be added to your card on file. *
Please type your first and last name as proof that everything on this form is accurate and true. *
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