Because you've taken our Relationship Quiz on the web,
we'd like to give you gift:

A free, detailed assessment
of your Relationship.

In exchange for your time, we'd also like to give you a
$20 gift certificate
for a romantic dinner for two*
or a gift of equivalent value.

Please enter your name and phone numbers and we'll call you to set up a time to visit our Mt. Airy, Philadelphia offices
for a 30 minute assessment of your relationship:

(Note: all communications with Two Rivers Mediation are completely confidential)

Name:
Partner's Name:
Day Phone:
Evening Phone:
Email (optional)

*We won't waste anyone's time or money. In return for taking this positive step towards healing your relationship, after consulting with us we'll either give you a $20 gift certificate towards a romantic dinner for two if working with us doing Couple's Mediation is right for you, or a $20 gift certificate to our NVC** class so you and your partner can work on your relationship together, and try the class out for free.

**NVC stands for Non-Violent Communication. It's a simple, four-step process that makes it possible to talk about things which are either hard for you to say, or hard for your partner to hear. Check out our website or the NVC website for more details.