Is A Couples Intensive Right For Me

Please answer these short questions that I’ve designed to help you and I see if an intensive is right for you.

Have you had couples therapy before?*

Yes

What was your prior experience with couples therapy like? (i.e. frustrations, successes, etc.)

How important is it for you to get the tools and skills needed to improve your relationship now? (1 being most important, 5 least important)*

1	2	3	4	5

What prompted you to reach out to me today? (Select the most important)*

Lack of Communication

Sexual Intimacy

Affair or Possibility of an Affair/Inappropriate Relationship

One or both thinking of leaving the relationship/marriage

Other

Do you want to say more about the lack of communication issues?

Do you want to say more about the lack of sexual intimacy issues?

If Affair, Which partner is having the affair or suspicious of one

My Partner

Both

Which of you are thinking about leaving the relationship/marriage?

My Partner

Both

Other

How satisfied are you with your current sexual relationship? (1 being very satisfied, 5 not satisfied at all)*

1	2	3	4	5

Which best describes your relationship now?*

We are just roommates living in the same house

We are staying together for the kids but we are miserable

One or both of us wants something better or different

One or both of us wants to leave

Something else

To have a relationship that you say you want will require an investment of your time and money. How motivated are you to invest in that now?*

How motivated do you think your partner is to invest in your relationship?*

Is there anything else you want to tell me?*

What do you think would be a good next step?*

We’d like to schedule a complimentary consultation: I’ve talked to my partner, and we have read about your intensives here on your website.

I have a few more brief questions: I have read about your intensives here on your website but I’d like to ask you a few more questions.

I’ll get back to you. I’d like to talk to my partner to see if they would be open to an intensive with you.

I’m not really clear about how the intensive works: I need more information.

I’m looking forward to talking with you further. Please let me know any questions you have and if you’d like to schedule a consultation.

Great, here is the couples intensive page that might help you and your partner discover more about it. When you’re ready, feel free to email me at lori@loriweisman.com with any questions.

Name

First Last

Message