subject_line
COACHING SERVICES
MINISTER PATRICK C. O'CONNELL
Personal Information
Your First Name
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Your Last Name
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Address 1
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Address 2
City
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State
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Zip Code
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Your Phone Number
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Your Email Address
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SERVICES
What type of Coaching Services are you interested in?
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Pre-Marriage Check-up
Marriage
Relationship
Blended Family
Coping with Separation
Separation Recovery
Coping with Divorce
Divorce Recovery
Life Planning
Parenting
Co-Dependency
Spiritual
Other
Other
Briefly describe your challenges.
What are your goals?
Have you ever had professional guidance in this area before?
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Yes
No
What time frames would work best for you?
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🛈
Sunday 6 am to 11 am
Monday 6 am
Monday 5 pm to 8 pm
Tuesday 6 am
Tuesday 5 pm to 8 pm
Wednesday 6 am
Wednesday 5 pm to 8 pm
Thursday 6 am
Thursday 5 pm to 8 pm
Friday 6 am
Friday 5 pm to 8 pm
Saturday 6 am to 11 am
Is someone else willing to participate in these coaching sessions with you?
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Yes
No
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