Returning Deliverance Questionnaire

Please complete this form prayerfully and honestly before your deliverance session.

All responses are kept confidential.

Returning Deliverance Session Form

First

Last

Date of Birth

Email Address

Phone Number

Emergency Contact Phone Number

Since your last deliverance session, what changes or breakthroughs have you experienced?

Are there any areas where you feel the enemy may have re-entered or gained ground again?

Since You Stated "YES" Above, state below those areas.

Have you engaged in anything knowingly or unknowingly that may have reopened a spiritual door?

Since you Stated "YES" Above, What Things?

Are there any new symptoms, struggles, or manifestations you’ve experienced since the last session?

Since you Stated "YES" Above, What Are Those New Symptoms?

Have you been consistent in applying what was encouraged after your last session?

Since You Answered "NO" Above, State Below What You Haven't Been Doing

Are there any specific areas you want to focus on in your next session?

Is there anything else we should know before your upcoming session?

Are You Looking For An In Person OR Remote Deliverance Session?

Select Deliverance Session Date & Time

I have read and agree to the Terms and Conditions of the Kingdom Alliance Ministries Deliverance Agreement!