Your responses to these questions are confidential, seen only by me and our staff counselors.

To keep things simple, I've used the term "marriage" to describe your relationship. If you are in a long-term relationship but not married, then consider each question as referring to your committed partnership.

APPLICATIONS WILL NOT BE PROCESSED UNTIL BOTH PARTNERS HAVE FILLED OUT THIS ONLINE FORM. If you are the first one to complete the application, please ask your partner to fill theirs out as soon as possible.

Tim Tedder, LMHC, NCC
AffairHealing.com | TimTedder.com