FREE INDEED MINISTRIES AUSTRALIA

P.O. Box 356, Dapto NSW 2530 Australia

Email: freeindeed.ministries.australia@gmail.com.
Website: www.freeindeedministriesaustralia.com

Application for Prayer/Healing/Counselling/Deliverance Ministry

Free Indeed Ministries Australia willingly offers the prayer and healing ministry to all who long for
freedom from sicknesses, mental or spiritual damage from prior events &/or relationships, deep
doubts or fears, devastating feelings of inadequacy or guilt, feelings of deep despair, suicidal
thoughts etc. We acknowledge that we all have held on to “baggage” from various experiences and
backgrounds, and such baggage can be a major hindrance in our daily lives. Therefore, it is our aim
to minister to you by coming alongside you and assisting you in dealing with any such things that
hinder your growth and maturity. Before we can provide a client with personal ministry, however, it
is important that following form be completed.

Free Indeed Ministries Australia is very eager and committed to helping people be free of
sicknesses, mental or spiritual damage from prior events &/or relationships, deep doubts or fears,
feelings of deep despair, suicidal thoughts or similar. Furthermore, we offer this service entirely free
of any monetary cost. However, we also respect the person’s fundamental human rights, dignity,
responsibility and free will. Therefore, any choices, decisions or courses of action that you take after
receiving ministry help from Free Indeed Ministries Australia must be made yourself, at your own
expense and risk.

Free Indeed Ministries Australia’s ministers are all trained and equipped to be able to offer ministry
and quality general advice to people who have sought and agreed to receive such ministry, and will
offer the best possible ministry support and general advice. However, it is still the responsibility of
the counselee to make their own choices of actions and be responsible for their own actions.

By signing this consent form you agree to participate in receiving ministry from Free Indeed
Ministries Australia but releases Free Indeed Ministries Australia and its ministers from any liability
for subsequent choices, actions or consequences.

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 FREE INDEED MINISTRIES AUSTRALIA
P.O. Box 356, Dapto, NSW 2530 Australia
Email: freeindeed.ministries.australia@gmail.com.
Website: www.freeindeedministriesaustralia.com

-CONFIDENTIAL INFORMATION-

Name: ____________________________ Today's Date: _________________________

Address: _______________________________________________ __________________________
Phone: __________________________
Age: ________ Birthday: ____________
Marital Status: Single Married Divorced Remarried Widowed
(Please circle which one applies to you)

Please briefly answer the following:

1. Please describe as clearly as you can what was it that prompted you to seek prayer ministry?
What is the most painful or difficult issue for you at this time? For example, relationship issues with
your Father, Mother, siblings etc, phobias, fears, stress, emotional hurts, addictions, physical
afflictions.

2. Have you previously received personal ministry in the area of deliverance or inner healing?
Yes or No
If yes please describe the experience

3. Have you ever been involved in the occult or other religions? (e.g.: witchcraft, spiritism, séances,
or Islam, Jehovah’s Witnesses, Mormon Church, Buddhism, etc.)
Have you or any members of your family past or present been involved in any fraternities, covens,
Freemasons or any other secret societies?
Please list:

Free Indeed Ministries Australia © June 2019 Page 2

4. What is your church background? Denomination(s) and or church experience if any. Are you
currently receiving ministry from your church? Please give brief details:

5. Have you ever accepted Jesus Christ into your life and if you have accepted Jesus Christ do you
have assurance of salvation from consequences of sin?

If you have never received Christ, would you like the opportunity to do so because He is the One
who heals and delivers!

6. If the answer to the above question is YES, one of our prayer team will address this before the
actual healing or deliverance ministry.

7. Have you ever been baptized or taken part in any sort of initiation ceremonies? Yes or No
If yes, when and please give brief details:

8. Are there any other problems you feel this questionnaire hasn't addressed? Please explain:

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 FREE INDEED MINISTRIES AUSTRALIA
P.O. Box 356, Dapto, NSW 2530 Australia
Email: freeindeed.ministries.australia@gmail.com.
Website: www.freeindeedministriesaustralia.com

Consent:
I have been informed that the ministry of prayer/healing/counselling/deliverance is based on the
teachings, ministry, life, death and resurrection of the Lord Jesus Christ. Any advice provided during
the counselling/ministry will be from trained, skilled and accountable ministers and will be
administered with respect of my confidentiality and be of a general nature (not, for example,
Financial advice which is subject to State and Federal legal regulation, and must only be offered from
Certified Financial Advisors). Likewise, while the advice offered may have some psychological
aspects, the ministers of FREE INDEED MINISTRIES AUSTRALIA do not claim to be professional
specialists in the field of Psychology and make no false claims to be recognised by the Australian
Psychological Association.

I further understand that the session will be conducted by trained prayer ministers. There may also
be intercessors present who will be praying for me throughout the session to receive God’s healing
and direction.

I recognize that this step of faith has been helpful for many but has not been scientifically proven. I
understand that I might experience heightened emotions and memories that were previously
subconscious or unresolved, that neither I nor any other person knew about in advance. I
understand that there is a possibility that one or more of these memories may be screened or false. I
will not hold Free Indeed Ministries Australia or any of the Prayer Ministers or Intercessors
responsible for my memories or behaviours. Further sessions may help resolve these issues if the
memories are found to be true.

I give my consent for prayer ministry, and am in no way being forced, pressured, or coerced to
submit to this procedure from any person or entity. I also have the right to terminate the
prayer/healing/counselling/deliverance sessions at any time without penalty.

I understand that there is not a guarantee of continued or ongoing prayer ministry with Free Indeed
Ministries Australia’s team members. Free Indeed Ministries Australia’s prayer team members
reserve the right to discontinue a prayer session at any time for any reason as they feel led. I also
appreciate that all such prayer/healing/counselling/deliverance sessions are offered free of charge.

I do understand that if - I give any indication that I am currently suicidal or if there is new
information about a current molestation of a minor or any other current criminal activity - the prayer
minister is obligated by law to report this immediately to legal authorities.

Free Indeed Ministries Australia © June 2019 Page 4

I am signing my name below as a legal acknowledgment that I have been informed of my rights,
entitlements and responsibilities and release Free Indeed Ministries Australia and its ministers from
any liability for whatever subsequent actions I may take.

Signed:

Date:

Free Indeed Ministries Australia © June 2019 Page 5