Vision & Goals
Staff & Board
Vision & Goals
Staff & Board
Personal Prayer Appointment Registration
DISTRICT OF COLUMBIA
FEDERATED STATES OF MICRONESIA
NORTHERN MARIANA ISLANDS
U.S. MINOR OUTLYING ISLANDS
ARMED FORCES AMERICAS
ARMED FORCES PACIFIC
PRINCE EDWARD ISLAND
Emergency Contact Name
Emergency Contact Phone Number
If you are part of a church, which one?
18 - 25
26 - 35
36 - 45
46 - 55
56 - 65
66 - 75
76 - 85
I found CHC by:
If referred, who referred you?
What, if anything, has prompted you to schedule a personal prayer appointment?
Briefly describe your relationship with God:
Is this your first prayer (inner healing) appointment? If not, when and where have you received prayer before?
Do you have a preference for the make-up of your prayer team?
No preference - mixed is fine
Do we have your permission to share your story with anonymity for the purpose of testimony or as a learning tool for those in training with this ministry?
Yes, share freely
Yes, but only for training purposes
LIABILITY RELEASE FOR CHRIST HEALING CENTER MINISTRIES
I fully understand that team members from Christ Healing Center Ministries have voluntarily agreed to pray for me. I realize that this session is not professional counseling and that no one on this prayer ministry team is a licensed counselor.
I acknowledge that this service is provided free of charge. I acknowledge I have sought assistance of my own will and realize that I am under no obligation to accept or reject any information received during this prayer time.
I understand that in agreeing to receive ministry from the Christ Healing Center Prayer Ministry Team, the team is bound by honor to respect personal information shared, so long as it does not prove to be a danger to myself or others to do so.
I promise to hold Christ Healing Center Ministries and its team members free from any and all liability, loss or damage of any kind that arises as a result of services I have received at Christ Healing Center or by a Christ Healing Center team member.
I have read and fully understand this Liability Release and acknowledge that I am purposefully waiving personal rights I may otherwise have against Christ Healing Center Ministries and its volunteers. Being of sound body and mind, I voluntarily execute this Liability Release as indicated by my form submission and electronic signature below.
I have read the above paragraphs and agree in full:
Yes, I agree
No, I disagree and will not attend a prayer session
If under 18, Parental Electronic Signature - As guardian, I agree to all parts of the attached consent form for my child to receive prayer from CHC ministries prayer team:
We encourage you to reach out to one or two people you feel comfortable with and ask them to pray for your time at the center. It can also be helpful to meet with them after your prayer time to share what you experienced and what God did in your time at CHC.
Powered by NeonCRM
Share Christ Healing Center on...
135 W. Olmos Drive San Antonio, TX 78212
210-930-7760 Fax: 210-930-7778