PRE-SESSION QUESTIONNAIRE

STEP 1: Complete the Pre-Session Questionnaire
Take a few minutes to tell me about you, your situation, and your current or past guy. It takes about 10-15 minutes but must be completed before our first session. Take your time, grab a cup of coffee or tea and give it your undivided attention.

First Name

Your age

What is your current Relationship status?

Have you been married before? How long? When did you get divorced?

Do you have children?

How long have you been interacting/talking to him?

How did you meet?

Does he have children?

Has he ever been married?

When did you last see him in person?

When did you last text or talk on the phone?

Did he cheat on you?

Is he still married? Or with his Girlfriend? Do they still live together?

How are you feeling right now?

Where do you feel the most stuck?

What do you need to accomplish with these coaching sessions to make it worth the time and financial investment?

What was the relationship like before him? How long did you date/see each other? Where did you meet? Is he/was he married? (Your previous relationship with you ex) Feel free to provide any other relationship history if you would like.

Tell me who your other primary relationships are in your life? Who do you talk to about things? Who do you feel are your true friends?

Do you feel embarrassed or shameful about your situation? If so, why?

How do you want to feel at the end of the three sessions?

Would you like ongoing group coaching support?

PRE-SESSION QUESTIONNAIRE

Join Our Free Trial