PRAYER MINISTRY APPLICATION

You’re 3 steps away from your ConnectUp session. . .

Step #1.
FILL OUT application

Please complete the application in its entirety.

Step #2.
watch Your EMAIL

Once your application has been reviewed, you will receive an email with a link to book your appointment.

step #3.
Book your appointment

We have session times available online and in-person. Choose which one works for you.

First Name *

Last Name *

Gender: *

MaleFemale

Email Address *

Phone *

Age *(must be 18 years or older)

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

How did you hear about us?

Have you been through an emotional healing session before? If yes, enter the date and context of your last session.

Are you currently under the care of a psychiatrist, psychologist, therapist, or licensed counselor?

Why would you like to receive emotional healing prayer? Are there any specific areas you are seeking breakthrough in?

Liability Release Form

The purpose of this ministry is for spiritual growth and healing. It is not a psychological counseling service, nor is it intended to be. Team members are not licensed psychologists or psychiatrists; however, they are trained in using the Word of God and prayer through the power of the Holy Spirit. The results of this approach depend on the willingness of the individual to make wise choices consistent with the teachings of Jesus Christ. All personal information gathered in the course of a ministry session is confidential, and the files are so maintained; however, information, as needed, may be shared with leaders of Radiant Life Ministries, Inc. to further my healing process. Radiant Life Ministries, Inc. prayer ministers may consult with other Radiant Life Ministries, Inc. team members without the use of individuals’ names. Discipleship, the commitment to train others in the mastery of prayer ministry skills, is an ongoing aspect of prayer ministry. Qualified disciples may be assigned during ministry sessions. The adherence to a strict policy of confidentiality includes disciples working with prayer ministers. Radiant Life Ministries will abide by all laws regarding the reporting of threats to self, threats to others, abuse of a child, abuse of the elderly and/or other behavior deemed by Radiant Life Ministries to be harmful to yourself or others. Regardless of local laws, and out of care and respect for God’s creation, Radiant Life Ministries will report any of the above to the proper authorities. Radiant Life Ministries will leverage technology including, but not limited to, Zoom and other video conferencing platforms. Radiant Life Ministries is neither responsible nor liable for the use of this technology or any issues related to the privacy and security of such technology. None of the participants will record any session unless all participants agree to the same. I understand the above information concerning this ministry. I have sought this ministry of my own free will and am under no obligation to accept or reject any of the advice or help that I might receive from the team members of this ministry. All personal information I reveal is given voluntarily in order to facilitate the team members working with me. I further release Radiant Life Ministries, Inc. from any and all liability, loss or damage of any kind that may arise or result from these ministry sessions.Acknowledge that you have read the Release Form and that you acknowledge and accept the guidelines stated above by entering your name in the fields below as your signature of acknowledgement and acceptance of the Liability Release Form guidelines.

First Name *

Last Name *

PRAYER MINISTRY APPLICATION

You’re 3 steps away from your ConnectUp session. . .

Step #1.
FILL OUT application

Step #2.
watch Your EMAIL

step #3.
Book your appointment

Gender: *

Liability Release Form

RADIANT LIFE MINISTRIES

RADIANT LIFE WORSHIP CENTER

OFFICE LOCATION

MISSIONAL COMMUNITY

TRANSFORMATION CENTER

PRAYER MINISTRY APPLICATION

You’re 3 steps away from your ConnectUp session. . .

Step #1. FILL OUT application

Step #2. watch Your EMAIL

step #3. Book your appointment

Gender: *

Liability Release Form

RADIANT LIFE MINISTRIES

RADIANT LIFE WORSHIP CENTER

OFFICE LOCATION

MISSIONAL COMMUNITY

TRANSFORMATION CENTER

Step #1.
FILL OUT application

Step #2.
watch Your EMAIL

step #3.
Book your appointment