Pre-Marital Questionnaire Form
This questionnaire should be filled out completely and turned in to the church office. After being
reviewed, an appointment will be made to meet with a pastor, at this time we will determine
whether or not to begin the pre-marriage counseling.
NOTE: We reserve the right to discontinue the counseling and planning process at any time, at
our discretion.
*****Both you and your fiancé can complete a questionnaire separately or together, but
both must be present for the actual Pre-Marital counseling with the pastor.
General Information:
Have you set a tentative date for your wedding? ____ If yes, when?_______________________
Personal Information:
Name: _________________________________________________ Age: _________________
Address:
______________________________________________________________________________
Home Phone: ___________________________ Work Phone: ___________________________
Fiancé’s Name: __________________________________________ Age: _________________
Marital Status:
Have you been married before? ________ If yes, how many times? _______________
If so, for how long? __________
Are you: Divorced _____ Widowed _____ Separated _____
Is your divorce final? _______ If not, why & when? ___________________________________
Do you have children from a previous marriage? ________ If yes, how many? ________
What are their ages? ________________________________________
If you are divorced, what is your custody arrangement?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
If divorced, why was your previous marriage terminated?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Engagement Period:
How long have you known each other? _________
How long have you been going together? _________________
How long have you been officially engaged?__ _____________
(We require that you have been dating seriously for at least eight months before we will begin
counseling)
What brought you together?
______________________________________________________________________________
______________________________________________________________________________
Religious Background:
Are you a Born Again Christian? _____________
Briefly describe what it means to be Born Again:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Do you regularly attend a church? ________
If yes, which one? ______________________________________________________________
For how long and how often? _____________________________________________________
Please answer the following questions as completely yet as briefly as possible. Remember that
our goal is to help you prepare for marriage. Please be honest with your responses. Don’t simply
write the answers you think we expect.
1. Write a definition of “Love”.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. How do you know you “love” your fiancé?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3. How have you prepared for marriage?
Have you read Christian books? _______
If so, please list them. _____________________________________________________
Have you listened to cassette tapes on Christian marriage? _______
If so, please list them. _____________________________________________________
Have you attended any marriage classes? _______
If yes, please describe them. _____________________________________________________
Have your parents ever been divorced or remarried? __________________________________
If so, why?____________________________________________________________________
4. What do you expect to receive from marriage that you cannot have staying single?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
5. Give some reasons why you want to marry your fiancé.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6. List any concerns about marrying your fiance.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
7. What do you see as your role in the marriage?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
8. What do you see as your mate’s role in the marriage?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
9. With so many marriages failing today, what guarantee will you have that your marriage
will remain successful?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
10. How do other members of your family feel about your fiance?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
11. How do you feel you are accepted by your fiance’s family?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
12. How will you handle conflict or disagreements
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
13. Do you plan on having children? If so, how many?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
14. Who will discipline your children and how?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
15. Who will handle your finances? If there are differences, how will you handle them?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
16. Thoughts and plans for emergency funds? (if appliance repair or emergencies arise)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
17. Creating a special time for dating. What plan do you have?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
18. What plans do you have to keep your marriage fresh and alive?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
19. Sports, TV, shopping and other boundaries and limitations you can be agreed on?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
20. Priorities on purchasing items other than using credit cards?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please Note:
Performance of marriage ceremonies is an accommodation to the body, NOT an obligation. It is
understood that entering into pre-marital counseling is NOT an agreement of approval to be
married by this pastor or anyone else at this church. We do not claim to be “Professional”
Counselors. Our counsel is based solely on God’s Word. Be sure you thoroughly understand our
position, before signing below:
I acknowledge that I have read and understand the above, and that all of the information filled in
is true and correct to the best of my knowledge.
____________________________________ _____/_____/_____
Signature of future husband Date
____________________________________ _____/_____/_____
Signature of future wife Date
Copyright © 2020 Pastoral Care Inc. All Rights Reserved. All material is intended for individual use only. Any other
use, such as distribution, promoting one's ministry or adding to websites, is prohibited unless written permission
granted by Pastoral Care Inc.
This form was provided by Pastoral Care, Inc. at www.pastoralcare.com
