Couple Therapy Booking Form

About Couple Therapy Booking Form

The Couple Therapy Booking Form is designed to streamline the process of booking a couple therapy session. This form allows couples to easily provide their contact information, preferred date and time, and any additional details or requirements they may have.

Couple Therapy Booking Form Questions

Full Name: This question asks for the full name of the person booking the couple therapy session.
Email Address: This question asks for the email address of the person booking the couple therapy session.
Phone Number: This question asks for the phone number of the person booking the couple therapy session.
Preferred Date: This question allows the couple to specify their preferred date for the therapy session.
Preferred Time: This question allows the couple to specify their preferred time for the therapy session.
Message: This question provides an optional space for the couple to leave a message or additional information.
Are you currently in a relationship?: This question asks the couple to indicate whether they are currently in a relationship or not.
On a scale of 0 to 10, how would you rate the current state of your relationship?: This question asks the couple to rate the current state of their relationship on a scale of 0 to 10.
What are your main reasons for seeking couple therapy?: This question asks the couple to provide their main reasons for seeking couple therapy.
Have you attended couple therapy before?: This question asks the couple if they have attended couple therapy before.
If yes, please provide details: This question asks the couple to provide details about their previous couple therapy experience.
Any additional information or specific requirements?: This question provides an optional space for the couple to provide any additional information or specific requirements.