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Name
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First
Email
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Phone
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What are the biggest challenges you’re facing in your relationship right now? (Be as detailed as possible.)
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What best describes your education background
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High school or some college
Associate’s or Bachelor’s degree
Master’s degree
Doctorate or professional degree
What best describes your household income
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Under 75,000
75,000 to 149,999
150,000 to 249,999
250,000+
How committed are you to improving your marriage right now?
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Ready to take action now
Serious but exploring
Unsure/ Just gathering info
If working with us feels like the right fit, are you ready to make a 4 figure investment to save your marriage?
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I’m ready to invest in myself and my marriage — this is a top priority.
I’m ready to invest and would prefer a payment plan or financing options.
I’m not in a place to invest right now, but I want clarity on my situation.
We have a zero-distraction, no-driving policy for calls. Can you commit to being in a private, quiet place for your session?
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Yes
No
If your call is missed or late, we may not be able to reschedule. Do you agree to honor your commitment and show up on time?
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Yes
No
Comments
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