Marriage Assessment Form

We're glad you've decided to take the next step in growing your marriage. Please take a moment to fill out this form below so that we can be able

Full Name *

First Name Last Name

E-mail *

Phone Number

Area Code Phone Number

How long have you been married?

Have you been to any marriage counseling/ministry?

Yes No

What do you feel have been roadblocks in your marriage?

What are your expectations from receiving marital ministry?

What do you believe to be a healthy/successful marriage?

What area(s) do you feel you both excel in with your marriage?