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Be Heard - Couples Group Coaching

Couples Group Coaching

This is the registration and intake process to help us form our groups. Please answer honestly.  You will be contacted soon regarding the next step in the process. All emails will come from WE WILL WIN. 
1.Couples Full Name(Required.)
2.Best email contact(Required.)
3.Relationship Status(Required.)
4.How long have you been in the relationship?(Required.)
5.Current issues you are experiencing (select all that apply)(Required.)
6.Please provide a brief background of your situation. (Required.)
7.When are you ready to start?(Required.)
8.How did you hear about us (this group coaching)?(Required.)
9.Best Day & Time (cst) (select all that apply)(Required.)
Current Progress,
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