靈活關懷中心預約表 Soul Care Center Reservation Form
親愛的家人/朋友 平安,
首先,謝謝您對SCC 的信任!請您完整填寫下列表單,提交後我們將盡速與您聯絡,以確認並安排相關事宜。

★ 鼓勵您委身於教會小組,讓牧長得知您預約SCC服事,可以在禱告中為您守望。衷心祝福您在真理建造、牧養關懷、屬靈遮蓋等信仰基石中,逐步且穩健地走向全人的健康。

★ SCC 是以聖經教導為主協談為輔的全人關懷中心,服事者與協談員為受過相關專業訓練之教牧輔導人員,而非領有政府核發執照的諮商心理師。

★ 所有服事與輔導需經由受輔者的參與及奉獻支持,方得以運作。每項服事均有建議奉獻金額,並由社團法人台灣城市引力協會開立奉獻收據。再次感謝您的支持,願神賜福!

中文姓名 Name in Chinese *
Your answer
性別 Sex *
西元生日 Date of Birth *
MM
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DD
/
YYYY
目前婚姻狀態 Current Marital Status *
行動電話 Mobile Number *
Your answer
電子信箱 E-mail *
Your answer
通訊地址 Address *
Your answer
請問您是否已受洗?Have you been baptized? *
目前所屬教會 Current church *
是否參加小組?Do you participate in groups in church? *
小組名稱/小組長姓名 group's name/leader's name *
Your answer
請問本次您想預約的項目?What type of appointment do you need? *
請問您是否接受過上述任一輔導/服事?若有,請簡述項目及時間。 Have you participated in any of the services stated above? If yes, which one(s) and when? *
Your answer
請問本次預約的主要原因?What led you to appointment this time? *
Your answer
若上述原因已造成您的困擾,主要反應在哪些議題中?(可複選) Where does the issue stated above occur in your life? (multiple answers) *
Required
請問您從哪裡得知靈活關懷中心的訊息?Where did you learn about SCC? *
Your answer
您是否願意接受本中心為您安排合適的輔導/服事者?Are you willing to accept the counsellor we arrange for you after the assessment? *
請在此簡述任何您想分享的事情。 Anything else you want to share with us?
Your answer
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