Client Intake Form: Couples | The Perfect Partner

Tell me about your last relationship

How do you feel about your partner

Describe your relationship

What would you want your partner to work on

What’s going on in your relationship

What problem(s) are you struggling with?

What do you dislike about your relationship or what to be different?

On average, how often do you argue or have disagreements in your relationship

Let's talk about your dating and relationship challenges.

What happens during arguments/disagreements (check all that apply)

Yelling at each other

Cussing or calling each other out their name

Physical altercation

One or both shuts down and refuses to talk

Do you have the same arguments repeatedly?

Describe your last argument

Tell me about your dating and relationship goals.

What are your primary goals for relationship coaching?

What specific outcomes do you hope to achieve through coaching?

What expectations do you have for the coaching process?

Just a couple of more questions.

What challenges are you currently facing in your relationship?

Are there specific issues or concerns you'd like to address in coaching?

Describe your communication style in the relationship.

How would you describe your partner's communication style?

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