Christ-Centered Counseling Inquiry Form

Full Name(Required)

Email(Required)

City/State/Country(Required)

Age(Required)

Occupation or other primary endeavor

How did you hear about AYSF? What interests you about working with AYSF in particular?

What sorts of issues are you interested in addressing in counseling?

Have you ever been in any kind of counseling before? How would you describe the approach of the counselor? How helpful did you find it and why?

How would you describe your relationship with God these days?

How would you hope to benefit from AYSF Christ-Centered Care? What outcomes would be satisfying to you?

What days of the week/ times of the day are you available to meet for one hour at a time on a weekly basis (please provide at least 3 options):

Do you have any questions at this time?

We are typically able to respond to inquiries within 72 hours.