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Divorce Coach Helping Jewish Families Thrive
Before the
Courage
, the
Housekeeping
*
Kindly complete these questions before our first session and then,
let's get going!
Let's Talk About You.
Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
(###)
###
####
Email
*
(###)
###
####
Age
Occupation
What's your go-to karaoke song?
Now, About Your Family.
Children?
If so; name, age, where they live
And Your Relationships.
Current relationship status
If single, how long have you been single?
Ever married?
Yes
No
If yes, years married
Divorced?
Yes
No
If yes, when?
MM
DD
YYYY
Widowed?
Yes
No
If yes, when?
MM
DD
YYYY
Who's In Your Pit Crew?
Have you engaged a dating coach or matchmaker before?
Yes
No
If so, names of matchmakers with whom you've consulted
Are you currently using dating apps?
Yes
No
If yes, which ones?
Do you have any regular destinations for travel? If so, where?
Thank you!
*with apologies to Jack Kornfield, author of
After the Ecstasy, the Laundry
(Bantam, 2001).