Pre-Marital Christian Counseling Intake Questionnaire
Personal Information
Name (Partner 1)
Name (Partner 2)
Date of Birth (Partner 1)
Date of Birth (Partner 2)
Phone (Partner 1)
Phone (Partner 2)
Email (Partner 1)
Email (Partner 2)
Relationship Information
Engagement Date
Planned Wedding Date
How did you meet?
How long have you been together?
Spiritual Background
Church Attended (Partner 1)
Church Attended (Partner 2)
Describe your Christian faith (Partner 1)
Describe your Christian faith (Partner 2)
What spiritual practices do you engage in together?
Family & Background
Briefly describe your family background (parents, siblings, upbringing):
Previous marriages or children? Please explain:
Relationship Strengths and Areas of Growth
What do you see as strengths in your relationship?
What areas would you like to grow in as a couple?
Concerns & Expectations
Do you have any concerns going into marriage?
What are you hoping to gain from pre-marital counseling?
Additional Comments
Anything else you’d like to share?