FromRoot2Fruit | Deliverance Consultation & Intake Form

Full Name

First NameLast Name

Birth Date

MonthDayYear

Cell Number

Format: (000) 000-0000.

Email

What is your primary reason for seeking deliverance prayer and spiritual support?

Have you accepted Jesus Christ as your Lord and Savior?

What areas of your life are you seeking prayer, freedom, or spiritual support in? (Select all that apply.)

Have you ever participated in any of the following spiritual practices or experiences? (Select all that apply.)

Are there any people, situations, or past experiences involving hurt or unforgiveness that you would like prayer and support with?

Are you willing to participate in prayer, biblical discipleship, personal reflection, and making changes that support your spiritual growth and freedom in Christ?

Would you be interested in ongoing biblical discipleship, Bible study, prayer, or spiritual mentorship following your consultation?

Have you previously participated in a deliverance prayer or ministry session?

Are you currently connected to a church, pastor, or Christian spiritual community?

Are there any medical, emotional, or mental health concerns that you would like us to be aware of to help make your prayer consultation safe and comfortable?

Please read and acknowledge the following: FromRoot2Fruit provides Christ-centered prayer, biblical encouragement, and discipleship support. I understand that:My participation is voluntary, and I may stop at any time.Prayer and deliverance ministry are not substitutes for medical or mental health treatment.I should continue prescribed medications and professional care unless advised otherwise by my licensed healthcare provider.I may ask questions or decline any prayer activity that makes me uncomfortable.Question: Do you understand and voluntarily agree to participate under these conditions?

How did you hear about FromRoot2Fruit Ministry?

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FromRoot2Fruit Ministry — Important Notice

FromRoot2Fruit provides Christ-centered prayer, biblical encouragement, and discipleship support. Participation is voluntary.

Our ministry services are not a substitute for professional medical care, mental health treatment, or counseling from licensed professionals. Participants should continue any prescribed treatment and seek appropriate professional assistance when needed.

All personal information shared through this consultation form will be handled with care and respect for privacy, subject to our stated privacy practices and applicable law.

Consent & Acknowledgment — I confirm that I have read and understand the FromRoot2Fruit Ministry Important Notice. I understand that participation is voluntary, ministry services do not replace professional medical or mental health care, and I consent to submitting this consultation form.