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COUNSELING AGREEMENT
I, the
undersigned, agree to the counseling methods and
procedures offered through Bethel Colony of Mercy,
Inc. I understand that my counseling may involve
prayers, Bible reading, Scripture writing, spiritual
warfare, Biblically based homework, and the use
of inexpensive Christian resources. I understand
that the basis for the counseling is the infallible,
inerrant, plenary word of God (The Bible) and that
the ministry emphasizes the moral absolutes depicted
in the Scriptures and not moral relativism.
Signed
:
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| "Not
lagging behind in diligence, fervent in spirit, serving
the Lord; rejoicing in hope, persevering in tribulation,
devoted to prayer" Romans 12: 12 |
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| Name: |
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| Email
(so we may reply) |
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| Age: |
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| Date: |
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MARK ANY OF THE FOLLOWING THAT APPLY TO YOU
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| DESCRIBE
YOURSELF IN THE PAST YEAR:
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| DESCRIBE
YOURSELF:
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| MY
BIGGEST PROBLEM IS:
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| MY
SECOND BIGGEST PROBLEM IS:
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| MY
THIRD BIGGEST PROBLEM IS:
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HAVE YOU DONE WRONG TO ANYONE?
Y OR
N |
| HAVE
YOU EVER PHYSICALLY HURT ANYONE?
Y OR
N |
| HAVE
YOU EVER TRIED TO COMMIT SUICIDE?
Y OR
N |
| DO
YOU DRINK ALCOHOL?
Y OR
N |
| DO
YOU USE DRUGS?
Y OR
N |
| HAVE
YOU EVER BEEN MARRIED?
Y OR
N |
| DO
YOU HAVE A GIRLFRIEND OR BOYFRIEND?
Y OR
N |
| HAVE
YOU EVER BEEN DIVORCED?
Y OR
N |
| ARE
YOU DEPRESSED A LOT?
Y OR
N |
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DO YOU BELIEVE THE PRINCIPLES AND PRECEPTS SET
FORTH IN SCRIPTURE ARE WITH-OUT ERROR?
Y OR
N |
| DO
YOU BELIEVE IN GOD?
Y OR
N |
| DO
YOU BELIEVE GOD HAS THE RIGHT TO TELL YOU HOW TO LIVE?
Y OR
N |
| ARE
YOU WILLING TO COME UNDER THE AUTHORITY OF THE WORD
OF GOD AND ALLOW IT TO DIRECT YOUR LIFE?
Y OR
N |
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MARK ANY
OF THE FOLLOWING THAT YOU THINK YOU MUST DO TO GET TO
HEAVEN
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