• Counseling Agreement

  • I understand that the counseling received at Grace Biblical Counseling Ministries will be based on the Counselors understanding of the Bible. I agree to always be completely honest with the Counselor, to make every effort to keep the appointments that are set, and to cancel any appointments that cannot be kept by notifying the counseling ministry at least 48-hours in advance, if possible.


    I further understand that the ministry sessions are structured to last between fifty-minutes and one-hour. I will honor the Counselor's time by adhering to that time constraint unless, by joint-agreement, we decide to extend the session longer. Session lengths can be shortened at any time during the session by the Counselor or the Counselee.


    Finally, I understand that these sessions are extended as a ministry of Morrison Heights Baptist Church, and are offered as a part of the church's overall ministry to its members and the community. Morrison Heights Baptist Church makes no claims of being a state licensed counseling organization.

  • Date*
     - -

  • Parental Consent Counseling Agreement

  •  I understand that the counseling my child receives at Grace Biblical Counseling Ministries will be based on the Counselors understanding of the Bible. My child and I agree to always be completely honest with the Counselor, to make every effort to keep the appointments that are set, and to cancel any appointments that I cannot keep by notifying the counseling ministry at least 48-hours in advance, if possible.


    I further understand that the ministry sessions are structured to last between fifty-minutes and one-hour. I will honor the Counselor's time by adhering to that time constraint unless, by joint-agreement, we decide to extend the session longer. Session lengths can be shortened at any time during the session by the Counselor or the Counselee.


    Finally, I understand that these sessions are extended as a ministry of Morrison Heights Baptist Church, and are offered as a part of the church's overall ministry to its members and the community. Morrison Heights Baptist Church makes no claims of being a state licensed counseling organization.

  • Date*
     - -

  • Personal Data Inventory

  • Date of Birth*
     - -
  • Format: (000) 000-0000.

  • Health Information

  • Rate your health*
  • Date of last physical exam:
     - -
  • Are you currently taking medications?*
  • Have you experienced severe emotional upsets before?*

  • Religious Background

  • Would you describe yourself as a saved believer in Jesus Christ?*
  • Are you a member of a local church?*
  • Average attendance of church:*
  • Are you baptized?*
  • Do you pray?*
  • Do you read the Bible?*
  • Do you have family devotions?*
  • Do you consider yourself religious?*
  • Do you believe in God?*
  • Do you read the Bible?*
  • Do you pray?*

  • Personality Information

  • Have you previously had counseling/therapy?*
  • Words that describe you (Select all that apply):*

  • Family Information

  • Are you married?*
  • Date of Marriage
     - -
  • Spouse willing to attend counseling?
  • Ever separated?
  • Filed for divorce?

  • First Questions

  • Should be Empty: