Pre-Marital Counseling Form For Couples

[Intended Couple's Form]

Today's Date

Bride's Name

Groom's Name

Bride's email

Groom's email

Intended Bride's Phone #

Intended Groom's Phone #

Bride's Age

Groom's Age

Bride's Address

Groom's Address

Name of Wakil

Wakil's Email

Wakil's Phone #

Date of Marriage

Presiding Imam (if you have a preference):

Do you agree that a marriage announcement will be made to the general public

Yes No

I agree to undergo Islamic counseling for a minimum of four sessions and one session post marriage for a total of five counseling sessions in as many weeks.

Yes‎

I agree to undergo standardized STD testing prior to consummation.

Yes‎

I understand the marriage cannot be conducted without the consent of the Wakil.

Yes‎

I agree there will be an acceptable "Mahr" (dowry) offered and accepted by myself as the intended bride.

Yes‎

I understand that I will be advised as to what are my rights as a Muslim husband/wife.

Yes‎

Wedding Venue

Number of guest (not to exceed 50 ppl) including witnesses

Additional Comments:

Bride's Digital signature

Clear

Groom's Digital signature

Clear

Terms of Service

The fee for the above services is $250.00. We have both read UMM's Marriage Policy. We swear by Allah (swt) we agree to the terms of service and all required fees.

NOTE: Weddings must be performed 30 minutes after salat and cannot begin 30 mins prior to salat. If your intention is to have a ceremony that will require greater than an hour we recommend a private facility be acquired for that purpose.