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Crossroads Freedom Form
Please fill out this form and someone from the Crossroads Freedom Team will work to schedule a freedom & prayer appointment with you. The information you share on this form is confidential and will not be shared beyond the members of our freedom team who pray with you.
Also, please be aware that we have an enemy who does not want you to be free, so don't be surprised if this process is tough! Press through. " So humble yourselves before God. Resist the devil, and he will flee from you." - James 4:7
We're excited to join you on your freedom journey of faith!
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Name
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First and Last
Your answer
Please provide your email address:
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Your answer
Please provide your cell phone number:
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Your answer
Date
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MM/DD/YY
MM
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DD
/
YYYY
Which of the following best describes the sense of urgency you feel?
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Regularly fear what I may do to myself or others
Sometimes fear what I may do to myself or others
Struggling a great deal, please help soon
Interested in help whenever it is available
Interested in going through this Ministry for my own growth, but am in no hurry
Why are you seeking freedom prayer for yourself?
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Your answer
What are your expectations and desires for receiving freedom ministry prayer?
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Your answer
Briefly describe any previous personal ministry, prayer, or counseling experiences, including when, who with, and the outcome.
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If this does not apply to you, please write "not applicable."
Your answer
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