Group Dating Coaching Form
Please answer all the questions. Submitted forms will be reviewed in the order received.
Basic Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Getting To Know You
What is your current dating status?
Single
Dating
It's Complicated
Situationship
How long have you been in your current dating status?
Weeks
3-6 months
6 months-1 year
1 year+
5 years+
Why have you been in this dating status?
Why do you think you need coaching?
Why do you want group coaching instead of one-on-one coaching?
Final Questions
What area do you think you need the most help with?
Faith: compromising
Type: dating different people who are essentially the same person
Confidence: the way you view yourself
Boundaries: not sure how to set them or how to say no
What other ways have you tried to fix what you're struggling with?
Friends
Professionals (therapy, etc)
Self help books
Social media
How important is your faith to you?
1
2
3
4
5
Do you pray about your current dating status?
Yes
No
Not sure how to pray
What is your relationship with Jesus like?
Anything else you'd like to add?
Submit
Should be Empty: