Prayer Counseling Intake Form
Thank you for inquiring about Prayer Counseling Ministry at Calvary Church. The intake is confidential and will only be seen by the Prayer Counseling Pastor, Desiree Elrod. She will contact you in the next 1-4 business days to schedule a consultation. During the consultation Desiree will do an intake and explain what PCA is. After attending a consultation, 5 prayer sessions will be offered  if you're wanting to move forward.  
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What is your first and last name?  *
Email Address?  *
What is your phone number?  *
Gender *
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Birthday?  *
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How did you hear about the Prayer Counseling Ministry? *
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Can you give the name of the person who referred you and their professional/church/ministry affiliation, if applicable?  *
What church are you affiliated with, if any? *
What brings you to Prayer Counseling at this time? *
What is your availability?  Knowing your level of flexibility will help us to schedule appointments more efficiently. Please check which time slots applies to your availibility. (Please know that we are typically booked so the more time slots that you can check off, the faster I will be able to schedule you.) *
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