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Couples Counseling
Please fill out the form below as detailed as possible so that we can get you lined up with the most appropriate avenue of healing.
First Name
Last Name
Email
Phone Number
Age
Name of significant other
First Name
Last Name
Age of significant other
Are you a member of Living Hope Church
Yes
No
If not, how often do you attend
Have you previously met/spoken with a leader from Living Hope about your situation?
Yes
No
Status of relationship
Length of relationship
Reason for seeking help
Relationship strengths
Relationship risks and concerns
Counseling goals
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