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CBL Counseling/Care Request
CBL provides biblical counseling and care for ministry leaders and their families.
For more information about CBL, visit
www.CBL.org
.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Ministry Status
*
Current vocational pastor
Spouse of a vocational pastor
Current vocational missionary
Spouse of a vocational missionary
Current ministy leader
Spouse of a ministry leader
Current seminary student
Spouse of a seminary student
Other:
How did you hear about CBL?
(Check all that apply.)
*
Church
Conference
Friend
Website/Social Media
Other:
Required
Please indicate if you are associated with one of our partners:
Biblical Eldership
Immanuel Network
Shepherd's Staff
222 Foundation
Name of Ministry
*
Your answer
Gender
*
Female
Male
Phone #
*
Your answer
Local church
*
Your answer
Marital Status:
*
Single
Married
Other:
Spouse Name (if applicable)
Your answer
Spouse Phone # (if applicable)
Your answer
Spouse Email (if applicable)
Your answer
What is your request?
*
Your answer
Please rate the urgency of your request:
*
Not a big concern just looking for guidance
1
2
3
4
5
A major concern that affects all of life
What have you done about this request? (e.g. I've spoken with a pastor, I've sought professional counseling, etc.)
*
Your answer
Is your church/ministry leadership supportive of you receiving care through CBL?
*
Yes
No
Other:
Appointment Type Preference
*
In-Person
Virtual
Other:
What type of appointment are you requesting?
*
Individual counseling
Marriage counseling
Family counseling
Mentoring
Staying on Mission Program (8 sessions, year-long individual or marriage counseling)
Marriage on Mission Program (weekend marriage intensive)
Other:
Additional Comments:
Your answer
A copy of your responses will be emailed to the address you provided.
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