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Build a Better Relationship After Infidelity
Walk Away From Porn
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REBUILDING US Infidelity Recovery Coaching
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First Name
Email
How long have you been together as a couple?
If youโre married, how long have you been married?
If you have children together what are their ages?
When did the infidelity occur, and how long ago was it discovered?
Are both of you committed to stregnthening your relationship?
What resources, if any, have you already tried in order to help your relationship?
What are your primary goals for concierge coaching?
On a scale of 1-10, how would you rate your current level of trust in the relationship?
What is your household income range?
Under $100,000
$100,000 - $150,000
$150,000 - $200,000
$200,000 - $250,000
$250,000 - $300,000
Over $300,000
This program requires a significant investment of both time and financial resources. On a scale of 1-10, how willing are you to invest in healing your marriage?
What specific challenges or obstacles would you like to work on?
What strengths do you believe your relationship has that will help in the coaching process??
Are there any religious or spiritual beliefs that are important to your healing journey?
Do either of you have any mental health diagnoses or are you currently in individual therapy?
What expectations do you have for this coaching program?
How did you hear about the Rebuilding Us Infidelity Recovery Coaching Program?
Is there anything else you'd like us to know about your situation?
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