Begin Your Intake Process

Name *

First Name

Last Name

Phone

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Which best describes your connection to a local church right now? *

I am actively involved (serving, in fellowship, accountable to leadership).

I attend regularly but have not taken steps to serve or connect deeply.

I attend occasionally but do not feel rooted in a church body.

I am currently seeking a church home.

When you think about your church attendance, what motivates you most? *

I go because I love Jesus and I desire to worship Him with His people.

I go because I know it’s good for me, but my heart isn’t always fully engaged.

I go mainly out of habit or obligation.

I am still exploring faith and haven’t committed yet.

How would you describe the role your church plays in your spiritual growth? *

Primarily a place I attend on Sundays – it’s important, but I don’t have much connection beyond services.

A source of encouragement and teaching – I benefit from sermons and worship but have limited accountability or deeper fellowship.

A community that challenges and supports me – I grow through small groups, relationships, and shared service.

A spiritual family where I am accountable and discipled – my growth is rooted in love, correction, and walking with others in Christ.

Which one best describes what does discipleship mean to you? *

Learning more about the Bible – mostly knowledge and information.

Having someone guide me in my faith – mentorship or advice when I need it.

Walking alongside others who encourage me in obedience – sharing life, being challenged to grow.

Loving Jesus through surrender, accountability, and transformation – being shaped to look more like Him in every area of life.

Which best describes your daily walk with Christ? *

I seek Him daily in prayer, scripture, and obedience.

I pray and read sometimes, but I struggle with consistency.

I rarely pray or read scripture outside of church.

I am still learning what it means to walk daily with Him.

Session Length & Commitment *

Deliverance sessions are scheduled in 3–4 hour blocks, with a minimum of two sessions required. Please confirm your understanding of this structure by reading and checking all the boxes below:

I understand that each session will last 3–4 hours; I understand that I am committing to a minimum of two sessions.

Which best describes your current discipleship/mentorship in your church community? *

I am actively discipled in my church through leaders, small groups, or mentors.

I attend church but do not currently receive regular discipleship or accountability.

I have not found discipleship available in my church setting.

I am currently seeking a church home and do not have discipleship in place.

Our first recommendation is always that discipleship take place through your own church community. If this is not available, you may request a Faith-Based Mentorship Plan through God’s Good Service. *

Please confirm your understanding:

I understand that mentorship is ideally provided by my church community.

I understand that mentorship offered by God’s Good Service is a faith-based ministry plan, not professional counseling or therapy. *

Please confirm your understanding:

I understand

I understand that any mentorship plan provided will focus on prayer, scripture, and spiritual accountability. *

Please confirm your understanding:

I understand

I request to be considered for a Faith-Based Mentorship Plan. *

Please confirm your request:

I request to be considered for a Faith-Based Mentorship Plan (if my church cannot provide discipleship).

My church CAN provide discipleship AND I request to be considered

I do not want to be discipled

Please confirm that you understand this mentorship is not professional counseling or therapy, but a faith-based ministry service rooted in prayer and scripture. *

Yes

No

I understand that all payments are non-refundabledonations to support this ministry. . *

Yes

I understand that deliverance sessions are faith-based ministry, not counseling, therapy, or medical treatment. *

Yes

All sessions are offered as a faith-based ministry. To preserve confidentiality and mutual trust, clients agree not to share details of sessions in public forums, social media, or online reviews. Any concerns should be addressed directly with leadership for resolution. By participating, you acknowledge that this ministry is not liable for personal opinions expressed publicly about services received. *

Yes

Is there anything you would like us to know before your session? *

Yes

By submitting this form, I confirm that I understand and agree to the terms outlined above. *

Yes, I agree.