ATTENTION: The more you answer the questions below. The better I can assist you. Please complete and return this form. It will be used solely for the purpose of helping you take hold of your freedom in Yeshua (Jesus Christ). If you are taking this appointment self-direct, this form will be used if you wish to set a zoom appointment with Bianca. This form is confidential and you will receive a copy after the appointment. We also can destroy it and keep no record of it. The only form kept of your appointment is the basic Statement Of Understanding that you will be asked to complete just before you begin.
A. Personal Information
B. Family History
Identify whether your parents were strict or permissive in regard to thefollowing:
C. Family Health
D. Physical Health
E. Thought Life & Emotional Health
H. Spiritual Areas
G. Problem Areas
4. If you have not covered the basic teaching, we will usually ask you to do so before we makean appointment.
5. I understand that my participation in completing this Confidential Personal History and inthe Freedom Appointment is totally voluntary on my part and that I am not under anyobligation whatsoever. I understand that the person who will lead me through the Steps toFreedom is not necessarily a professional counsellor or therapist, but a fellow Christian who ismaking himself/herself available to pray with me and guide me through the Steps to Freedom.Therefore I voluntarily ask for this appointment and assume responsibility for my responses asa result of this prayer ministry
Next Step – This Confidential Personal History has a double purpose. It is a further preparatorystep for you, by helping you focus on issues to pray about as you go through the Steps toFreedom.
This Freedom Appointment is ran by Bianca L. Gibson, Freedom in Yeshua Ministries. Youshould satisfy yourself as to our credentials, and contact us if you have any concerns about theprocess.
Declaration by the person going through the freedom appointment:
I understand this is not a counselling appointment, and that the staff of the Ministry statedabove and those associated with them, are not professional or accredited counsellors, normedical or psychological practitioners.
I understand that everything I share during this encouragement experience will be keptconfidential and that I alone hold the right to release any information.
However, I am also aware that if the staff of the Ministry suspect that a child (under the age of18 years); a vulnerable adult; or an elderly person (over the age of 65 years) is currentlyendangered by abuse; or if I am a danger to myself or others, they will inform the appropriateauthorities, and I give my consent to this.
I understand that I am under no financial obligation, I am here voluntarily, and am free to leaveat any time.
I deem the persons facilitating this appointment to be encouragers in the Christian faith, andthey are here to help me assume my responsibilities for finding freedom in Christ.
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