Personal Testimony Survey

Please fill out each question to the best of your abilities. Type N/A in any comment boxes that don't apply to your story.

Please note: By filling out this survey, you are giving your consent to Christian Healthcare Ministries (CHM) to use the information you provide (including your name, your image, and/or any interview statements) now or in the future in CHM’s publications, social media, print media, electronic media, advertising, or other media or promotional activities. This consent is given in perpetuity, and does not require prior approval from you.

1.What is your name?(Required.)

2.Why did you join Christian Healthcare Ministries?(Required.)

3.Tell us a bit about your journey and how CHM factors in.(Required.)

4.What were the highlights (or lowlights) of your story that you are comfortable sharing?(Required.)

5.What has God taught/been teaching you?(Required.)

6.Are you self-employed?(Required.)

Yes (As a self-employed person, what do you appreciate about CHM?)

7.Have you ever needed to use your CHM membership?(Required.)

Yes (Explain how that went)

8.Did you interact with any CHM Staff?(Required.)

Yes (Explain how that went)

9.Have you received cards, letters or prayers of encouragement from fellow CHM members or staff?
Were there any moments where you felt ministered to?(Required.)

10.Every story is unique. Is there anything else to your story that you’d like to share?(Required.)

11.Would you be willing to share your story in a video format?(Required.)

I’d be willing to be interviewed by CHM’s Video Team.

I’d prefer to record myself on my own phone.

I’m open to either option but would like more info.

I'm not willing to share my story in a video format.