Emotional Healing Ministry Application & Liability Release - Confidential Information
Redeeming Freedom Ministries 
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Email *
First and Last Name *
Phone *
Mailing Address *
Age *
Gender *
Marital Status *
Church *
Describe your relationship with Jesus *
Why do you wish to receive Emotional Healing? *
Do you have any illnesses or chronic pain? *
Do you attend a bible study or small group? *
Have you received Emotional Healing before? If so, when and with what ministry? *
How did you hear about us?  *
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