Prayer Appointment

Name

Phone( ) -

Are you over the age of 18?*

Yes

If not, you will need the permission of a parent or legal guardian and we will confirm the appointment with them.

Have you ever received freedom or healing prayer before?*

Yes

What is your preferred date? Please choose a date which is at least 2 weeks out as we are usually booked that far in advance. Thank you!

The length of this appointment will be between 90 minutes to 2 hours.

What is your second preferred date? Choose a date at least 2 weeks out.

Is there anything else you would like us to know?

Did someone refer you?

Yes

If so, please provide their name

Please leave this field blank.