Couples Coaching Registration Prequalification for Couples Coaching * We are legally married * We are NOT in couple's counseling of any kind * Neither of us is in treatment for drug or alcohol abuse * Neither of us is dating someone other than our spouseCONTACT INFORMATIONName * Name First First Last LastSpouse Name Spouse Name First First Last Last Email for Coaching Correspondence * Town/City * State/Province * Country * Are either of you eligible for the 10% USA police/military rebate? Yes No For USA Military or Police: Upload proof of service for your 10% rebate * Drop a file here or click to upload Choose File Maximum upload size: 5MBCOACHING PREFERENCESPreference for Coaching Sessions * Phone Skype Zoom Phone Number * Skype Address * Email where you want the Zoom link sent * Preferred Coaching Time * Morning Afternoon Evening Anytime Specific days and times only... Specify availability for your time zone * Living Situation * Living Together NOT Living Together Brief description of why you are seeking coaching * * We consent to the terms of the Coaching Agreement. If you are human, leave this field blank. Go to Payment Page
