Hebron Baptist Church - KY - Biblical soul care form

Consent for Soul Care at Hebron Baptist Church

Our Goal- Our goal in providing “Soul Care” 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.
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 “Soul Care” is based solely on scriptural principles rather than those of secular psychology, psychiatry, or the wisdom of this world. (I Corinth. 1:6-7) Confidentiality- Confidentiality is an important aspect of the “Soul Care” process, and we will carefully guard the information you entrust to us. However, because we are continually training others to be effective counselors and “Spiritual Buddies” we ask that you agree to allow counselors in training and Spiritual Buddies to be present during your sessions.

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.
(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 (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. 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 Hebron Baptist 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.
Church Attendance- It is required that counselees attend (on a regular weekly basis) Sunday morning services at Hebron Baptist Church and possibly life groups during the week. Having clarified the principles and policies of our “Soul Care” ministry, we welcome the opportunity to minister to you in the name of our Lord Jesus 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 these guidelines are acceptable to you, please sign below.

Signature

PERSONAL DATA INFORMATION FORM

This form must be completed in full before the first discipleship session. All information is confidential.

First Name

Last Name

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Occupation

Sex:

Male

Female

Birthdate

Health Information

Rate your health

Good

Average

Declining

Other

Have you had any recent weight changes? (Weight gain or loss? How much?)

Are there relevant medical conditions or prescriptions that we should be aware of?

Have you used drugs for other than medical purposes?

Yes

If yes, what have you used?

What is your educational background?

Other training (list type and years)

What are your personal study/reading habits?

Answer the Following Questions:

(Initial Assessment)

1. What is the problem as you see it?

2. In what way(s) have you contributed to the problem?

3. What have you tried to do already to resolve the problem?

4. As you see yourself, what kind of person are you? Describe yourself.

5. What, if anything, do you fear?

6. What can we do? (What expectations do you have of us?)

7. Is there any other information that we should know?

SPIRITUAL CONVICTIONS QUESTIONNAIRE

Finish the following sentences with two or three answers each.

1. God is

2. Jesus Christ is (describe who you think He is, what He has done, what He is doing now, what place He has in your life, what He means to you, etc.)

3. My relationship to God and his Son Jesus Christ is (describe the kind of relationship you have with God and how important that relationship is—be specific)

4. A Christian is

5. The Bible is

6. I know that I am (or am not) a Christian because

7. The Bible is (describe what you think it is, what it means to you, what place it has in your life, how you use it, etc.)

8. Sin is

9. My chief sins are

10. When I sin, I (describe how you handle sin, what you feel when you sin, what you do after you sin)

11. I feel guilty when

12. I pray (when, how, why, what for, etc.)

13. My chief goals in life are

14. I want (or do not want) to attend and be involved in church (answer the questions "how" and "why")

15. I believe fellowship with other Christians is (define what it is, what it involves, how important it is, and how it can be developed)

16. I am promoting my spiritual growth and the spiritual growth of others by

17. The changes I would like to make in my own spiritual life are

18. I would be happy if

19. I want

20. I get angry when

Review your answers. Are there any that you would like to change? Which ones? Why? Are there any to which you do not know the answer? Which ones? Compare and discuss your answers with your partner. Write down your impressions of this study. What have you learned about yourself and what have you learned about your partner? What changes do you need to make in light of this study?

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Consent for Soul Care at Hebron Baptist Church

PERSONAL DATA INFORMATION FORM

Health Information

Religious Background

Answer the Following Questions:

SPIRITUAL CONVICTIONS QUESTIONNAIRE