Questionnaire Form

Article Index


Do you often see yourself:

Eat in your dream? __Yes /No__

Fight in your dreams? __Yes / No__

Sexual activities in your dream? __Yes / No__

Do you See dead relativives in your dream? __Yes / No__

What do you want from this program

Counsel only? __Yes / No__, Deliverance only? __Yes / No__

Counsel and Deliverance? __Yes / No__

Have you undergone any Christian deliverance? __Yes / No__

Is this your first time contacting this ministry physically? __Yes / No__

How did you contact this ministry? By phone __Yes / No__

How did you hear about this ministry?______________________________________

Status: Married __Yes / No__, Single __Yes / No__, Divorced __Yes / No__

How many times have you been married?___________

How many children do you have?_______

Top Ten Questions You Need To Answer.

We are trying to locate the source or root of bondage, these top ten questions can be very helpful and save a lot of time. Think of this as a miniature deliverance questionnaire.

1. What kind of bondage are you facing? Fears, depression, voices in your mind, mental illness, physical illness, mental torment, spiritual torment, financial lack etc.

2. Do you remember when the bondage started? What was happening around the time this bondage started?

3. Can you see any 'open doors' where the bondage may have entered through?

4. Have you or your ancestors been involved in the occult or any false religions? Including secret societies such as Freemasonry and also seeking occult power or knowledge from others, such as having a fortune told, etc.

5. Do you have ancestors or family members who have suffered from a similar kind of bondage?

6. How do you see yourself? (Do you feel guilty, low self-esteem, confident, etc?)

7. Is there anything in your life that has been or is currently troubling you?

8. Do you feel truly loved by God for who you are? (Be honest!)

9. What things have negatively impacted your life? (Traumatic experiences, deeper sins, bad relationships, etc.)

10. What was your relationship with your parents like when you were growing up?