PASTORAL COUNSELING REQUEST FORM

Thank you for taking the time to answer these following questions. These form submissions are completely confidential. Please note, Pastoral counseling only extends to those who have completed membership class. Pastor personally determines the best counseling dates based on his schedule. Thank you in advance for your flexibility and understanding.

Name (Required)

Email Address (Required)

1. Are you a member of A.R.C. City Church? If "Yes" please specify the date you became a member (Required)

If not, why? (Required)

2. Have you completed Growth Track? (Required)

If not, why? (Required)

3. Are you serving on our Dream Team? If "Yes" please share where are you currently serving: (Required)

If not, why? (Required)

4. Are you consistently attending Life Groups? (Required)

If not, why? (Required)

5. If you are requesting an appointment with Pastoral Staff, what is the purpose of your appointment? (Required)

Please briefly explain specifically what you are seeking counseling for: (Required)

6. Is this a follow up of a previous counseling appointment you've had with Pastoral Staff? (Required)

7. Were you given any assignments to complete; such as sermons or book readings? (Required)

Have you completed the assignment? If "Yes" please briefly explain your progress. (Required)

Based on Pastor's current appointments, these are the best time slots available. Please select the times that work best for you: *Counseling sessions last 45-60 mins max* (Required)

Wednesday @ 1:00pm

Wednesday @ 2:00pm

Wednesday @ 3:00pm

Wednesday @ 4:00pm

Thursday @ 1:00pm

Thursday @ 3:00pm

Thursday @ 4:00pm

If these hours do not work, please explain why? (Required)

Solve 6 + 3 = ?

ARC City Church

3737 Stilesboro Rd NW
Kennesaw, GA 30152

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