Page 17 | Love Life Ministries COCHUSA

Intake Form

Thank you for opening your hearts and taking the first steps toward strengthening your marriage through God’s truth and grace. It’s an honor to walk with you in this season, to listen, pray, and support your desire for deeper unity in Christ.

Jesus is the Answer

As we move forward, we’re trusting that the Holy Spirit will guide each conversation, heal every wound, and breathe new life into your relationship. This isn’t just counseling—it’s covenant restoration. You’re seen, loved, and lifted in prayer.

Name (Required)

Email Address (Required)

How long have you been married or together?

What inspired you to seek marriage coaching at this time?

Are there specific challenges or areas of concern you’d like to address?

What are your hopes and goals for your marriage?

Are there particular skills or tools you’d like to develop (e.g., communication, conflict resolution, intimacy)?

Are you both equally committed to participating in coaching sessions?

Would you prefer one-on-one coaching or group sessions with other couples?

How can we best support you in this journey?

Are you ready for premarital counseling?

What is your spouse/partner's name?

Solve 8 + 6 = ?

Love Life Ministries COCHUSA

4140 Union Church Road
McDonough, GA 30252

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