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  • Freedom Prayer Intake Form

    The purpose of this form is to obtain a picture of your background and present life. Please answer the questions as fully and accurately as possible. They will be reviewed by the Freedom Prayer Coordinator before your appointment and will be shared only with your Prayer Ministry Team. No one else will have access to this information without your approval.
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  • Part 1 of 7.  

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  • Spiritual History

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  • Part 2 of 7

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  • Emotional History

  • Part 3 of 7

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  • Family History

  • Father

  • Mother

  • Your Siblings


  • Grandparents


  • Part 4 of 7

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  • The Occult-

    Adapted from Christian Healing Ministries, Inc. School of Healing Prayer Level I
  • About the Occult

    One of satan's favorite weapons agaiinst us is occult involvement.  The occult (meaning "secret" or "hidden") is satan's world of the spirit.  Occult involvement means that we seek to gain knowledge or personal power from a spiritual source other than God.  The special danger of occult involvement is that it appeals to our spiritual hunger, which is our innate desire to find the Lord, and diverts us from Him into the occult underworld--a dead end.  It is also a form of idolatry.

    When we open ourselves up to the occult involvement, we violate the first commandment, "You shall have no other God but Me." (Exodus 20:3) and Jesus' commandment, "You shall love the Lrod your God with all your heart and with all your soul and with all your mind and with all you strength." (Deut. 6:4-9; Matt. 22:37; Mark 12:30; Luke 10:27).  Remember also that the wrong things that we do in innocence and ignorance hurt as much as the thing we do deliberately.

    Satan has set occult traps throughout our world into which he hopes that we will fall.  God's way of healing us through confessions, renouncement, and forgiveness works not only for our sins, but also for our errors and ignorance.

    As you read through the following list, ask the Holy Spirit to recall to your mind every involvement you have had.  Keep in mind that many of these activities are clearly of the occult, but the occult nature of some of them may not be as clear.  Please mark any and all possible activities, even if there is a question in your mind as to their occult nature, so that you are confident you renounce all possible occult or demonic influence in your life.

    Have you ever- just for fun, out of curiority, or in earnest, done any of the following?

     
  • Soothsayers/Fortune Tellers: (Deut 18:9-16; Daniel 2:26-28; Isaiah 2:6, 47:10-15; Micah 5:12; Acts 16:15)

  • Necromancy, Spiritualism (1 Sam. 28:7-11; II Kings 21:6; Isaiah 8:19-22; Leviticus 19:31, 20:6)

  • Occult Books, "Contact" Objects, and Other Media (Ex. 19:25-10:6; deut. 5:8-10, 7:46, 24-26; I Kings 14:7-11; II Kings 23:1-25; Ps. 97:7; Isa. 42:17; Acts 19-:19-20; II Cor. 10:3-5)

  • Sorcery or Magic (II Kings 17:17, 21:6; Isa. 47:9; Malachi 3:5; Acts 8:11, 13:4-12; Revelation 18:23; 21:8)

  • Sins of the Flesh, Sins of the Eyes (Matt. 5:28; Rom. 6:12-14; 7:7-25; 8:13-14; I Cor. 6:13, 18-20; 9:26-27; Gal. 5:16-21; I Thess. 4:3-8; James 1:14-15; I Pet. 2:11; I John 2:16)

  • Devil Worship (II Chronicles 11:15; Ps. 106:37; I Cor. 10:20-22; Rev. 9:20-21, 13:4)

  • Witchcraft (Gal 5:19-20; I Sam. 15:23, 28:7; II Kings 9:22, 23:24; I Chron. 10:13; Isa. 8:19, 19:3, 29:4; Micah 5:12)

  • Generational Influence (Ex. 34:6-7; Numbers 14:17-19; Deut. 5:8-10; Joshua 22:16-29; Ps. 33:11; Jeremiah 11:10-13; Acts 2:38-39)

  • Notice: We are obligated to report to relevant State agencies/law enforcement agencies any knowledge that we obtain of imminent or ongoing abuse, danger, or harm to others or yourself.

  • Part 6 of 7

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  • Release

    Freedom Prayer makes no claims of effectiveness, nor do we guarantee results of this prayer session. However, we do believe that God answers prayer and that He heals diseases. By signing below, you are agreeing to hold Wellspring Church, Freedom Prayer, their staff and volunteers harmless for any liability connected to this voluntary prayer session. We recommend that if you are currently taking medications or are operating under the advice of a professional service, that you allow that therapist or doctor, etc. to confirm results of prayer before you alter any prescribed course of action. This form and all data recorded on it are the sole property of Freedom Prayer of Wellspring Church. All content will be held in confidence for the sole purpose of ministry to the above except as indicated in the testimony release below
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  • Testimony Release

    All sessions are confidential; however, it is helpful to our ministry and to the Body of Christ to be able to report and hear results of healing prayer. Please check the appropriate statement and sign below to allow us to publish orally or in written form, testimony of any healing you receive here today.
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