Covenant Churches of East Texas - Deliverance Report

Minister Information

First Name

Last Name

First Name

Last Name

Please provide the phone number of the person you met with:

Date Input

List Everyone Present at the Session/on the Call:

What type of session was this?

If this does not need a follow-up, select No. If this does require one, please mark who needs to follow-up.

No

Me

Deliverance Pastors

Which of the two options do you prefer:

I will personally follow-up and schedule the appointment

I would like the office to follow-up and schedule the appointment

Will you contact the office before 3 PM on M-F to ensure there is a room available for your session?

Yes

Addition Comments or Notes (What was the strong hold of the session? Ex: Anxiety)