Biblical Counseling Request Form

First Name:*

Last Name:*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Phone*

DOB:*

Do you currently attend Horizon Christian Fellowship?*

If you attend Horizon, please list length of time you have been attending:*

If you attend a different church, please list name of church:*

Do you attend a Horizon Core Group?*

If you attend a Horizon Core Group, please list leaders name:

Have you been to Horizon for Biblical Counseling before?*

What best describes the reason of why you're looking for Biblical Counsel*

Feel free to briefly share about what you are seeking Biblical counsel for: