Strategic Consultation Application

Strategic Assessment Application

For couples considering ongoing counseling to address problematic patterns in their relationship.
This application is the first step of the Strategic Consultation — a four-session assessment for couples, ending in a feedback session where I share what I see and we decide together whether further work makes sense.

Two things to know before you write:

This consultation works on a no-secrets basis. What you share here may inform our conversations, including the joint session. Don't write anything here that you wouldn't want raised with both of you in the room. Anything you need me to know privately can wait for your individual session.

This is an assessment, not couples therapy. Its purpose is clarity — about the relationship and about whether and what kind of work fits. Sometimes the honest answer is that couples' work isn't the right next step. That answer is part of what you're paying for.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code

Does your partner know you're submitting this application? What would they say is the reason you're reaching out?
Are there any current or pending legal proceedings between you — divorce filing, legal separation, custody or support matters? If so, where do things stand?
Do you have children? Please list ages and who they live with.
Why now? Why this moment?
What are you currently struggling with or navigating?
What have you tried so far to work through this?
Is either of you currently in individual therapy or working with a coach? If you've done this kind of work before, what helped — and what didn't?

If this consultation goes well, what will be different — even slightly — by the end of it?
What outcome are you most afraid of? Be as honest as possible.
Has there been any point in the relationship when either of you felt physically unsafe, threatened, or afraid of the other — including during arguments? Is there anything happening now (drinking, threats, recent escalation) I should know about before we meet together?
If anything here feels unsafe to put in writing, leave it blank and call me directly.
This work is deep, direct, and emotionally demanding. Are you ready for that kind of engagement?

Are you interested in the four-session Strategic Assessment & Consultation, or in exploring ongoing or intensive work beyond it?
Preferred availability (days/times)
I typically work weekdays 9-12 and 2-5, with periodic availability outside those hours.

Strategic Assessment Application