Prayer Counselling Intake Form
Thank you for contacting Prayer Counselling Ministry.  

Should you require an appointment,  kindly complete this form as detailed as you can as this will help your prayer counsellors before they meet up with you, so as to have a more effective session. THIS FORM IS TO BE COMPLETED BY THE PERSON REQUESTING FOR A COUNSELLING APPOINTMENT.  Please be ensured that the information will be kept in STRICT CONFIDENCE.

Upon receiving your completed form, we will schedule you an appointment with 2 of our prayer counsellors from our team at our next available session.
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Email *
I request for prayer counselling via *
Are you referred by someone in our church? *
Name of your referral *
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