LET’S GET MESSY NOW

Name*

First NameLast Name
Meet with Joseph & Rachel
E-mail*
example@example.com
Phone Number*

Area CodePhone Number
Address*

CityState / Province

Postal / Zip Code
Occupation*
Facebook name, Instagram name, etc.*
How ready are you to dive into your life and marriage, getting raw and real? (Scale 1-10)*
Why are you this number? *
What are you desiring to get out of this session? *
Does Your Spouse/Significant Other Support You?*

YesNoN/A
Are they able to attend the session with you?*

YesNoOther
What are your top 3 goals in life? *
What’s held you back from achieving those goals? *
What consumes your thoughts the most? *
When Was The Last Time You Checked Your Credit Score?*

Less than 6 months ago6 months to 1 year1-2 Years
How do you feel about your Credit Score?*
Session Day/ Time Preference (EST, CST…)*
Meeting Preference*
Should be Empty:

Meet with Joseph & Rachel