Mentoring Program Form

When everything is on the line, you don’t need more noise, you need a trusted advisor who will keep your confidence and give you clarity.

Use the form below to start a private conversation with Dr. Angel. Every inquiry is handled with the highest level of discretion.

Get In Touch

All sessions are private and conducted virtually or in a location agreed upon with the client.

First name

Last name

Phone

By entering my phone number, I agree to receive SMS notifications about Dr. Angel or affiliates’ products, services, and marketing offers at the number provided. Message frequency may vary. Message & data rates may apply. Reply HELP for help and STOP to stop.

How many years have you been in your current relationship?

In what area of your relationship are you struggling the most right now?

How committed are you to healing your relationship?

Why do you want to stay in your relationship?

What solutions have you tried in the past to heal your relationship?

What could you do personally to promote satisfaction in your current relationship?

How would you rate the chances at the relationship improving?

Rate from 1 to 5, with 5 being the highest and 1 being the lowest.

How much are you willing to work at creating the desire to change?

What is the reason you waited to seek marriage mentoring?

I am willing to financially invest the following in my relationship:

Are you looking to use insurance for services provided?

To ensure the highest level of privacy and discretion, Dr. Angel’s services are not processed through insurance.

Do you prefer in-person or virtual appointments?

Message

I consent to receive SMS notifications, alerts, and occasional marketing communication from The Marriage Healer. Message frequency varies. Message & data rates may apply. You can reply STOP to unsubscribe at any time.