Marriage Intensive

A proven process to help couples who’ve lost hope.

Fill out the form below to start your mediation journey!

Client Information

First Name *

Last Name *

Phone *

Email *

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Spousal Information

First Name *

Last Name *

Phone *

Spouse Email *

Street Address *

City *

State *

Zip code *

How many years have you been married? *

Are you currently separated? *

Husband's Occupation *

Wife's Occupation *

Describe why you believe your marriage is struggling? *

Has there been any form of infidelity, addiction or abuse? *

Have you previously worked with an XO Marriage Mediator? *

How Did You Hear About XO Marriage Mediation? *