Need a Counselor?

"Where there is no guidance, a people falls, but in an abundance of counselors there is safety." Prov 11:14

To make an appointment, please complete the form below. This information is secure, encrypted, and only viewable by our counselors.


Date
Names
Phone number
Email address
Where do you live? (City, State)
Age
Gender
Marital status
How would you rate your health? Any health issues?
Are you taking any medication? If so, please list.
Do you attend church? If so, where and about how often?
Are you saved? If so, at what age?
Have you been baptized? If so, at what age?
How frequently do you read the Bible?
Do you have family devotions?
Explain any recent changes in your religious life.
Do we have permission to contact your pastor as deemed helpful by the counselor? If yes, please include pastor's name and contact information.
What brings you here?
What have you done about it?
What do you want us to do? (What are your expectations in coming here?)
What brings you here at this time?
In between meetings, the counselor will assign you projects for growth - things like Scripture to study, book chapters to read, etc. Will you commit to the personal study asked of you?
Is there anything else we should know?