Date
MM
DD
YYYY
Name
*
First Name
Last Name
Partners First & Last Name
*
Your Email
*
Your Phone
*
(###)
###
####
What is the best way to contact you?
*
Text
Phone Call
Email
What is troubling you or how would you like to grow?
*
What are you expecting from our time together?
*
Check all that apply:
*
Occupation / Employer:
*
Do you have a relationship with Jesus?
*
How would you describe your relationship with Jesus?
*
How did you meet each other? How long have you been together?
*
What area(s) of your relationship do you feel needs immediate attention:
*
(Ck. all that apply)
How would you rate your physical health:
Are you sexually active?
*
Yes
No
Have you seen a counselor, therapist, or pastor before?
*
Yes
No
PAUSE: Take a breath or two ... now, identify some of what you are experiencing currently:
*
Check all that apply.
When is your wedding date?
Location: (Place, City, State)
Do you need a wedding officiant?
Yes, we'd like that.
No, that's not necessary.
I have read, I understand, and I agree to follow the agreement above.
*
Additional Information about the Coaching Process
*
Your Relationship Coaching is intended to help you start conversations that will provide a solid foundation for your relationship. It is ideal to begin coaching 8-12 weeks prior to your wedding, and can be completed in 4/6 sessions. (More sessions may be needed in some cases).
Topics include but are not limited to: Topics will include: how you relate to marriage, communication, spiritual and sexual intimacy, the relationship dynamics, finances, boundaries, needs, expectations, and more.
Cost for Marriage Coaching: After completion of this form, you will be sent a coaching fee sheet that will detail cost, payment options, and other directions. The cost will include your sessions, SYMBIS assessment, and relationship resources.
Shortly after registration, you will be sent a SYMBIS assessment, which will be the basis of your marriage coaching. It's a fun, informative, and robust assessment on how you view marriage and will affirm you two as you take this sacred step into the covenant of marriage.
If you are in need of an officiant for your wedding ceremony, it is customary for the officiating licensed or ordained pastor to receive an honorarium (ranging $300 - $500) depending on the wedding arrangements and location.
If you have any questions, email douglasmlake@gmail.com
