Clients must electronically SUBMIT this questionnaire at least 48 hours before the first scheduled session.

Everything stated in the questionnaire is confidential.

Please fill out the form below by typing your answers and pressing the submit button at the end.

Please check your spam folder first if you have not heard from us within 3 to 5 business days.

By clicking the submit button, you agree to our Terms & Conditions.

Jazak Allah khayran.

PLEASE NOTE: We give priority to couples married for less than 5 years. If you are married for longer, you can fill out the form and we’ll check for availability.