PREMARITAL COUNSELING INTAKE FORM Today's Date MM DD YYYY Fiance Name (Female) * First Name Last Name Fiance Email (Female) * Fiance Name (Male) * First Name Last Name Fiance Email (Male) * Contact Mobile Phone * (###) ### #### Relationship Status Seriously Dating Engaged How long have you been dating? * Are you Believers (Christians)? * Yes we both are Neither of us are One of us is What do you hope to accomplish through pre-marital counseling? What, if any are your concerns about coming to counseling? * Is there any other information we should know to help us better serve you and your spouse? How did you hear about us? Thank you for submitting your Pre-Marital Counseling Form. Please check your email for your next steps. Thank You
