ICU For Couples Building Successful Personal Relationships For Professionals and the Entertainment Industry

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Application/Information Form

Give us a nutshell version of what you think the problems are in your relationship. All information provided here will be kept strictly confidential. See Your Privacy for more information.


Your Name
Spouse's Name
Address
City
State
Zip
Phone
E-Mail
Your Occupation
Spouse's Occupation
What do you think are the primary problems in your relationship?
What have you tried so far to correct the problem(s)?
How long have you been married?
How many times have you been married?
What would you say caused the problems in previous marriages?
Are you or have you been under the care of a mental health provider?	No Yes (if yes, please answer the following question)
If 'Yes', what are you working on?
Is there physical abuse or chemical dependency in the relationship?	No Yes Not Sure
Are both of you at least open to the possibility of saving your relationship?	No Yes Not Sure
Can you commit to one weekend (or 3-day mid-week commitment) once a month for 4-6 months?	No Yes
Please click the "Submit" button below when you have completed the form. Thank you.

"We wouldn’t have been married today without the Hedingers. There’s no way we could have made it." D. & H. C.

ICU For Couples - Marriage Help Save Marriage Restore Marriage

10 Things That Can Improve Your Marriage Now!

Be kind. Don’t say something so ugly to your spouse you would never think about saying it to someone you work with.

Catch ‘em doing something right. It’s so easy to see everything your spouse does that confirms just how awful they are. Switch your focus to catch them doing something right - no matter how small - and then tell them about it. (Besides, this will throw them completely off balance!)

Go do something fun…and it wouldn’t be fun to bring up anything that has been a problem; so don’t. Just remember what it was like to enjoy an activity together by doing something fun and keeping the conversation light.

>> "10 Things" Continues Here >>