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Premarital Counseling Initial Questionnaire

To My New Friends:

You completing this questionnaire because you have asked me to perform your premarital counseling (and perhaps your wedding, as well), and because I want to offer you the best premarital counseling that I am able to offer. I realize that I might not know you well – not yet! I trust that during counseling I will get to know you both much better. However, for me to counsel you well from the start, I need to ask some questions about who you both are, what are your backgrounds, what work is like for you, what your family was like growing up, and other things about you and your past.

In consideration for receiving any form of premarital counseling from me, Reverend Dr. Robert C. Scott. This letter will acknowledge that while receiving the counseling you both agree to release and waive any and all claims of any kind against the ministry, the staff, the premarital counselor(s) or the Church, which may arise from, result out of, or be related to conduct or advice given. Also, you are being asked to recognize that all counseling files and their contents belong to the St. Paul Baptist Church Pastoral Counseling Ministry.

Choosing your life partner is the second most important decision of your life. I will treat your appointment times with the respect and the seriousness that is due, and I asked that you do the same by keeping all set appointments or by notifying my Executive Assistant 48 hours before the set appointment. All counseling sessions must be completed at a minimum of 2 weeks before your set wedding date. If I am performing the ceremony, I may not agree to do such if the sessions are not completed by that time. There are no fees for your premarital counseling sessions, however, there maybe fees for certain assessment inventories that might be used. Your sessions with me are confidential except in cases where it is necessary to report the suspicion of child abuse, threats to harm self or others, or to receive supervision.

Be advised that I will assign homework. Homework is a vital part of the preparation process; therefore, completion of the homework assignments before your next session is expected. I will require the use of an excellent workbook, it is mandatory that you bring your workbooks to every session.

Sincerely,

Your Pastor

Revered Dr. Robert C. Scott
 
I have carefully read this online information sheet on the previous page and I agree to all of the stated terms and conditions*
You can not complete the form without agreeing with the terms.

Bride's Name*
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Bride's Email*
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Bride's Address*
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Bride's City/Sate/Zip*
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Bride's Home Phone
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Bride's Cell Phone
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Is the Bride employed?*
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Bride's Place of Employment
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Bride's Work Phone
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Bride's Birthdate*
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Bride's Age*
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Bride's Marital Status*
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Is the Bride Baptized?*
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If yes, what was the approximate of the Bride's Baptism?
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Is the Bride a Disciple of St. Paul?
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If yes, did the Bride finish CEO?
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When did the Bride finish CEO?
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Did the Bride Graduate High School or Obtain a GED?*
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If graduated/completed what certificates did the Bride receive?
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Did the Bride Attend a 2-year College?*
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If graduated/completed what certificates did the Bride receive?
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Did the Bride Attend a 4-year College?*
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Did the Bride Attend Post Graduate School?*
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Did the Bride Attend a Doctoral Program?*
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If graduated, what degree did the Bride receive?
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I have carefully read this online information sheet on the previous page and I agree to all of the stated terms and conditions*
You can not complete the form without agreeing with the terms.

Groom's Name*
Please let us know your name.

Groom's Email*
Please let us know your email address.

Groom's Address*
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Groom's City/Sate/Zip*
Please input your city, state, and zip code

Groom's Home Phone
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Groom's Cell Phone
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Can the Groom receive text messages?
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Is the Groom employed?*
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Groom's Place of Employment
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What is your job title?
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Groom's Work Phone
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Groom's Birthdate*
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Groom's Age*
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Groom's Marital Status*
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Is the Groom Baptized?*
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If yes, what was the approximate of the Groom's Baptism?
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Is the Groom a Disciple of St. Paul?
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If yes, did the Groom finish CEO?
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When did the Groom finish CEO?
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Did the Groom Graduate High School or Obtain a GED?*
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If yes, what is the name of the High School & Location (or location GED completed)
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Did the Groom Attend Technical School/College?*
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If yes, what is the name and location of the Technical School?
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What is the Groom's Technical Status?*
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If graduated/completed what certificates did the Groom receive?
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Did the Groom Attend a 2-year College?*
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If yes, what is the name and location of the 2-year College?
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What is the Groom's 2-year College Status?*
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If graduated/completed what certificates did the Groom receive?
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Did the Groom Attend a 4-year College?*
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If yes, what is the name and location of the 4-year Collegel?
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What is the Groom's 4 Year College Status?*
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If graduated degree did the Groom receive?
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Did the Groom Attend Post Graduate School?*
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If yes, what is the name and location of the Post Graduate School?
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What is the Groom's Post Graduate Status?*
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If graduated, what degree did the Groom receive?
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Did the Groom Attend a Doctoral Program?*
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If yes, what is the name and location of the Doctoral Program?
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What is the Groom's Doctoral Program Status?*
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If graduated, what degree did the Groom receive?
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First Choice Wedding Date*
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Second Choice Wedding Date
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Third Choice Wedding Date
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Where will the wedding be held?*
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Name of the Reverend who will perform the wedding:
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Best Time for Premarital Appointments*

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We will attempt to accommodate these times as our availability allows. The greater flexibility you can have with your schedule may allow for quicker placement.

Notes on the Best Day and Best Hour.
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