The Church in the Pines - TCITPFM INtake

Freedom Ministry Prayer Request Form

Pastor Chad and Connie Runge receive the intake forms and all information shared is confidential.

Birthdate

First Name

Last Name

Phone Number

Gender

Marital Status

Spouse Name or type none

Why did you make this prayer appointment?

What do you hope to accomplish at the end of our prayer time?

Is there a specific event weighing you down that you cannot get past?

Do you have recurring thoughts that trouble you? Briefly, what are they?

Do you “hear voices”? Are you seeking deliverance from demonic spirits?

Do you hear God speak to you? What has He been speaking to you lately?

Click all that apply

I have made Jesus my Savior.

I have made Jesus my Lord. (He leads my life.)

I have asked the Holy Spirit to fill me with His presence.

I have had a relationship with Jesus for a long time.

I want to learn more about Jesus being Savior, Lord, and the presence of His Holy Spirit.

Do you have any questions regarding the prayer session or a message for the intercessors?

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