Grace Fellowship Church
Financial Counseling Application
Our goal in providing biblical counseling is to help you meet the challenges of life in a way that will please and honor the Lord Jesus Christ and allow you to enjoy fully His love for you and His plans for your life.
We’re glad that you’re taking this important step to seek godly counsel. Jesus promises us, “Come to me, all who are weary and heavy-laden, and I will give you rest” (Matthew 11:28). No matter what your situation, this is a time in your life that the God of all creation knows and understands completely and therefore, there is great hope! This form is helpful for us to start getting to know you and your situation, as well as to communicate these first important points which explain some of our perspectives and convictions which we believe are honoring to God and the best way we can truly be of help to you.
Biblical Basis- We believe that the Bible provides thorough guidance and instruction for faith and life. (II Peter 1:3 and Romans 15:4) Therefore, our counseling is based solely on scriptural principles rather than those of secular psychology or psychiatry. In order to support this conviction, we ask that all of those we counsel to be:
* REGULAR ATTENDEES to our Sunday morning worship services,
*as well as ATTENDING A WEEKLY SMALL GROUP.
These are vital components to your growth in the Lord, and we would be glad to help you find a group that is most suitable to you.
Not Professional Advice- Although some of the pastoral or lay counselors of this church may be licensed in other fields, such as medicine or psychology, they do not practice as professional doctors, psychologists or psychiatrists in their role as Grace Fellowship Biblical Counselors. In this role, they do not provide the same kind of professional advice and services that they do when they are hired in their professional capacities. Therefore, if you have significant legal, financial, medical or other technical questions, you should seek advice from independent professionals not associated with Grace Fellowship Church. Our pastoral and lay counselors will be happy to cooperate with such advisors and help you to consider their counsel in the light of relevant biblical principles. By signing this “Consent to Biblical Counseling” you agree to hold Grace Fellowship Church harmless in any and all matters associated with the biblical advice you have received.
Confidentiality- Confidentiality is an important aspect of the counseling process, and we will carefully guard the information you entrust to us. However, because we are continually training others to be effective counselors we ask that you agree to allow the possibility of counselors in training to be present during your sessions. So as to bring as much understanding and grace to your counseling, your counselor and Small Group Leader will be discussing your progress of growing and changing to be more like Christ. Also, there are four other situations when it may be necessary for us to share certain information with others: (1) When a counselor is uncertain of how to address a particular problem and needs to seek advice from another pastor or elder in this church; (2) when a counselee attends another church and it is necessary to talk with his or her pastor or elders; (3) when there is a clear indication that someone may be harmed unless we otherwise intervene; or (4) when a person persistently refuses to renounce a particular sin and it becomes necessary to seek the assistance of others in the church to encourage repentance and reconciliation (see Proverbs 15:22; 24:11; Matthew 18:15-20). Please be assured that our counselors strongly prefer not to disclose personal information to others, and they will make every effort to help you find ways to resolve a problem as privately as possible.
Resolution of Conflicts- On rare occasions a conflict may arise between counselor and counselee. In order to make sure that any such conflicts will be resolved in a biblically faithful manner, we require all of our counselees to agree that any dispute that arises with the counselor or with this church as a result of counseling will be settled with mediation within the church according to the principles of scripture and the authority of this local church.
Having clarified the principles and policies of our counseling ministry, we welcome the opportunity to minister to you in the name of Christ and to be used by Him as He helps you to grow in spiritual maturity and prepares you for usefulness in His body. If you have any questions about these guidelines, please talk with a pastor or elder. If these guidelines are acceptable to you, please sign below.
I have read the above and am in agreement with the counseling policies of Grace Fellowship Church.
Additional Phone Number
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
What is your occupation?
Who is your employer?
What is your age?
How many siblings do you have and which number are you?
What is your parents' marital status?
Your marital status:
If married, what was the date of your marriage?
Have you been previously married?
If married, what is your spouses name?
If married, what is your spouses #?
If married, is your spouse willing to come in for counseling as well?
Do you have any children?
Please list Name and age
Please rate your general health
If you are taking any prescription medications, what are they?
Have you ever used drugs illegally?
Have you ever been arrested?
Are you willing to sign a release so that your counselor may write for social, psychiatric or medical reports?
Do you have problems sleeping?
If you have recently suffered the loss of someone who was close to you, please explain.
Education/Training (list type/years)
Do you consider yourself a Christian?
Grace Fellowship Church Status
Which campus do you attend?
How long have you been attending?
Which Small Group do you attend?
What church did you attend as a child?
What was your religious experience as a child? What was your home environment like in regards to Christianity, the Bible and the Church?
Do you consider yourself a religious person?
Do you believe Satan exists?
Have you ever "dabbled" with the Occult (seances, devil worship, witchcraft, etc) or been a part of a cult (Johovas' Witness, Mormonism, etc)?
Do you pray to God?
How often do you read the Bible?
Do you have a regular time of devotions?
I'm not sure what that means
PLEASE ANSWER THE FOLLOWING CONCERNING YOUR SITUATION:
What is your financial problem as you see it?
What have you tried to do already to resolve the problem?
As you see yourself, what kind of person are you financially?
What are your expectations in coming to counseling? How do you think we can help you?
Have you had previous financial counseling at Grace? With whom did you meet?
PLEASE BRING THE FOLLOWING TO YOUR FIRST SESSION:
1. List of debts (include the following for each debt):
- To whom the debt is owed
- Minimum monthly payment
- Total of debt owed
2. A list of expenses and three months of paycheck stubs (or previous year's W-2's)
3. Monthly Expenses Worksheet (located on Financial Application page)
6. Paper for note taking
Do Not Fill This Out