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Counseling Intake Form

Hope Begins Here

In order to prepare you for your first visit, we need you to complete the following form. Please answer questions to the best of your ability.


This form will take approximately 30 minutes to complete. Please plan to complete it in one sitting as it cannot be saved and continued later.

NOTE: We offer biblical counseling free of charge to our church and community on Thursday evenings between 5:00 pm and 9:00 pm. Please make plans to have your Thursday nights free for counseling. 

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