House of Healing Prayer Counseling Appointment Request
Welcome to the appointment request page. After filling out the form below we will email you to set up an appointment time. Our form is picky about every field being filled in, so if you don't have an answer for us just put an x in the field. When you're done you can submit your payment using the payment buttons below.
Name *
Your answer
Email Address *
Your answer
Phone (If email is not the best way to reach you)
Your answer
Gender *
Age
Your answer
How were you referred to us?
Your answer
Please give us a brief synopsis of the issue you would like to deal with. *
Your answer
Have you ever received 'sozo' or any other prayer counseling before? (If so where?) *
Your answer
How can we pray for you in preparation for your session?
Your answer
How would you like to pay? These will be done prior to receiving ministry. Payment will be asked for when appointment is scheduled. See payment buttons at the end of this document. *
Session Types and Fees. Please select an option. *
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