Deliverance Intake Form

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The Life Help team looks forward to helping you grow through prayer ministry. You must fill out and submit this form before we can schedule your appointment. It may take you 10 minutes or longer to complete this form.

Submitting this form does not guarantee your appointment. Someone from the Life Help team will contact you to schedule your appointment.

After submitting this form, you will receive an email confirmation with the contents of this form. Please print the email, sign it, and bring it along to your appointment.