CBL Counseling Request
CBL provides biblical counseling for ministry leaders.  For more information about CBL visit www.CBL.org
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Email *
First Name *
Last Name *
Ministry Status *
Name of Ministry *
Gender *
Phone # *
Local church *
Marital Status: *
Spouse Name (if applicable)
Spouse Phone # (if applicable)
Spouse Email (if applicable)
What is your request? *
Please rate the urgency of your request: *
Not a big concern just looking for guidance
A major concern that affects all of life
What have you done about this request? (e.g. I've spoken with a pastor.  I've sought professional counseling.) *
Is your church/ministry leadership supportive of you receiving care through CBL? *
Appointment Type Preference *
What type of appoinment are you requesting? *
Additional Comments:
A copy of your responses will be emailed to the address you provided.
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