Counselling Ministry

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* 1. What brings you here today?

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* 2. What is your name?

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* 3. What is your age group?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 4. Have you been in counselling before?

Yes

No

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* 5. If yes, how was your experience?

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* 6. What do you hope to see change and improve if you chose to do so with us?

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* 7. What is the best number to contact you at?