Mentor Form

Hello There,

I created this form to help you understand our relationship. I am a support system for you, who seeks to strengthen fragile areas--whether spirtual, soul, or physical. After the meeting (depending on your situation), a custom plan may be created. I make no claims to cure physical ailments or your soul or spiritual issue. That is up to G-d, in His time, & according to His will.

I've witnessed instant healing, but often, action is required (2 Kings 5:14)(John 5:8)(John 9:11)(Matthew 9:20-22). I've also seen G-d heal through other methods. Instructions are also given (1 Timothy 5:23)(Isaiah 38:21). If you want to see progress, please follow the plan I offer. Then, we can adjust things as we go along. I like to work with people who will be active participants in their whole health.

After this session, you can always book a follow-up meeting at your convenience.

God's Peace & Love,

Kim B. Vasquez

Christian counsel is provided freely. Healing gifts may be available for those who need it.

NAME*

First NameLast Name

TODAY'S DATE:*

MonthDayYear

E-MAIL*

Confirmation Emailexample@example.com

WHAT IS YOUR FOCUS FOR THIS SESSION?*

HOW DO YOU WANT ME TO HELP?*

Type*

Onsite (at our home base)Sick & shut in (30 mile radius)Public meetup (30 mile radius)

I AM 18 OR OVER*

YesNo

PLEASE CHECK THAT YOU AGREE TO THE FOLLOWING, EVEN IF YOUR FOCUS IS NOT ON PHYSICAL HEALTH.*

I am responsible for decisions regarding my health. I understand that Kim is not a secular medical doctor. However, I will provide pertinent health information, such as current ailments and prescriptions, if needed, to receive the right knowledge.

Please sign below. It does not have to be perfect, and you can use the whole space to sign.*