MarriedLife Help

Counseling Referral Request Form

Your Email Address:
First Name:
Last Name:
Age:
Years Married:
Spouse's Name:
Children & their ages:
ex: Billy - 9, Lucy - 4, Jake - 21
Campus You Attend:
Other:
Do you prefer a counselor closer to work or home?

Home Address

Street:
City:
State / Zip:
Home Phone:
ex: 888.888.8888

Work Address

Street:
City:
State / Zip:
Home Phone:
ex: 888.888.8888

1. For what are you seeking help?
2. When did you first notice this concern?
3. Had counseling before?
3a. If so, for what and where?
3b. What were the results of your counseling?

Directions

Browns Bridge Community Church is located on the Southeast corner of GA 400 and Browns Bridge Road (GA 369). Our address:

3860 Browns Bridge Road
Cumming, Georgia 30041-3927
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Buckhead Church is located at the corner of Tower Place Drive and Lenox Road in the heart of Buckhead. Our address:

3336 Peachtree Road
Atlanta, Georgia 30326
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North Point Community Church is located on the east side of North Point Parkway at Royal Drive, approximately 1-1/2 miles north of Haynes Bridge Road and approximately 1/2 mile south of Old Milton Parkway. Our address:

4350 North Point Parkway
Alpharetta, Georgia 30022
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About Us

Our mission is to help people experience the individual growth necessary for a healthy marriage.

Contact Us

For more information about MarriedLife, please contact us at Browns Bridge, Buckhead or North Point.

Store

North Point Resources records, duplicates, assembles, and ships CDs/DVDs to customers around the world.
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