Marathon Couples Therapy Application Marathon Couples Therapy Application Form Step 1 of 3 33% Partner 1 (You)*First Name + Last Name Partner 1 Mobile Phone Number* Partner 1 Email Address* Partner 2*First Name + Last Name Partner 2 Mobile Phone Number* Partner 2 Email Address* Relationship IssuesAre you facing (recently or currently) any of these issues in your relationship? Physical violence Affairs Drug or alcohol abuse Anger or extreme anxiety Depression Sexual coercion Property damage Humiliation Social isolation Jealousy Other issues? Disclaimer*I have confirmed with my partner that they are interested in attending a marathon and they have consented to me including their name in this enquiry. YES NO Comments or NotesAdd any further comments or questions below.
