Current relationship status:

Married

Long-term committed relationship

Engaged

Separated but actively trying to reconcile

Divorced/Preparing for next relationship

What describes your CURRENT marriage situation? Tick all that apply:

She's moved out, filed, or given a deadline that's already passed

There's been an explicit conversation about separating, or an ultimatum has been given

We fight/argue a lot, but nothing's been said about separating

Things feel distant, but nothing's been said outright

Wife cheating / seeing another man

Any domestic violence allegation or restraining order involving you and your partner

I have no way of contacting her (she blocked me)

How does your wife feel about you?

She still loves me, we're just going through a rough patch

She loves me, but is not IN love with me

She doesn't have feelings for me anymore

She hates me

Are you currently living together or separated?

Living together, same room

Living together, separate rooms

Separated 0–3 months

Separated 3+ months

What's going on right now, and what made you decide to apply today? (Please describe in detail for more value on call)

Have you tried counseling, therapy, or other programs? What happened?

Couples counseling

Individual therapy

Other coaching/programs

Books/Youtube videos

Nothing yet

What's at stake for you if nothing changes in the next 12 months?

What do you do for work?

Annual income? (USD)

Unemployed & No Income

Below $40k

$40k-75k

$75-$100k

$100k-$150k

Greater than $150k

Retired

Coaching with me is a significant investment, for men who are committed to fixing this. If you’re accepted, which best describes you?

Yes, I make my own financial decisions and can invest now

Money’s tight, but I could put at least $1,000 down to get help

I’d need my partner’s approval before investing in this

I can’t invest right now, I’m only looking for free help