HEALING                                                 Questionnaire
 
 

Name ______________________________________________ Date _______________________

Address ___________________________________________________________________________

City __________________________________________ State ________ ZIP ___________________

Phone ________________________________ E-mail ______________________________________

Born Again                                  Yes  No
Baptized in the Holy Spirit            Yes  No
Married                                       Yes  No         Spouse’s Name ______________________
Children                                       Yes  No

Physical Problem____________________________________________________________________

__________________________________________________________________________________

Under Doctor’s Care   Yes  No

Spiritual Condition __________________________________________________________________

__________________________________________________________________________________

Is Deliverance Needed?    Yes  No

     For what? _______________________________________________
 

Healing Team Members ______________________________________________________________

__________________________________________________________________________________

Comments:

Home Page:  awakening1s.net