Session Booking Form

Session Booking

Select an available date and time slot for your session. Complete the form information and click the Submit button. We will contact you to confirm your session.

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Partially booked

Time Slots*

First Name*

Last Name*

Email*

Phone

Do you have a relationship with Jesus Christ?

If you answered Yes to the above question, how do you know you’re saved?

How often do you read the Bible?

Are you Married Or Single

How many Years of Marriage?

How many Children?

Age of your Children

What have you done about your concern?

Why are you in Counseling?

Are you willing to allow the Holy Spirit work on you?

What are your Expectations from Counseling?

Are you willing to complete your Homework?

I have read the Disclosure?

I Understand and Agree With The Disclosure.

When Canceling My Session, I Will Notify My Counselor Two or more Days Before my Scheduled Session.

Session Booking

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