Schedule Your Coaching Session Now!

Please provide your contact info for your marriage rescue call

First Name *

Last Name *

Email *

Phone *

Let's get some details about your family

What is your spouse's name? *

How many years have you and your spouse been together? *

How many children do you have? What are their ages? *

Which of the following challenges are you currently facing in your marriage? *

Arguing

Feeling distant and disconnected

Our marriage is sexless

Someone is having an emotional or physical affair

Financial stress

I'm worried that we're going to break up

We're talking about separation or divorce

Divorce has been filed

Are you currently living in separate homes? *

Yes

No

How long have you been living in separate homes?

One month

Two months

2-6 months

6+ months

How often have you interacted with your spouse in the past month? *

Daily

Multiple times a week

Once a week

Twice or less

This includes: Seeing them face to face or having a phone or video conversation. It does not include texting. This includes conversations about kids, finances, logistics, small talk, etc.

On a scale of 1-5, how hopeful are you that your marriage can be saved and improved if you have the right tools and guidance? *

Why is it so important for you to resolve this NOW? *

To custom-tailor your marriage rescue plan we have a few quick questions about the health of the 3 key areas in life that impact the stress on and stability of a marriage (emotional, physical, and financial).

How are things going in other areas of your life (health, work, financial, etc)? *

What stage are you at in your career? *

Student
Entry-Level Job
Management
Self-employed
Business Owner with Employees
Stay-at-home Parent
I am retired
I am unemployed or on disability
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What is your profession and your title at work? What is your spouse's? *

Which best describes your financial stability? *

It's rock solid. If we had a financial emergency of $10,000 we have cash, retirement savings, or available credit to handle it

We pay all our bills on time, but if we were to miss a paycheck, something would go late.

Money is a constant source of stress, we don't have any funds or credit at all.

Select all that apply to your marriage: *

I'm trying to decide if I even want to stay in this marriage.

My spouse has a restraining order against me.

There have been allegations of child abuse.

There is currently physical abuse in the marriage.

Substance abuse is the BIGGEST problem in our marriage.

None of the above.

We do these sessions on Zoom (on camera) and want to make sure you have a solid internet connection and won't be driving. Please be in a safe space where you can dig deep, have an honest conversation, and be able to capture notes. Do you promise to show up for your scheduled appointment ON TIME and DISTRACTION FREE?

Confirm by typing "Hell Yeah" below *

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