Register for Inner Healing

We believe that discipleship must include inner healing, the renewing of the mind, and freedom from spiritual bondage. Many are wounded, rejected, or traumatized—and need more than teaching; they need restoration. Jesus came to heal the brokenhearted and to set the captives free. Discipleship is not only about knowledge but also about emotional, spiritual, and generational transformation through the cross, the Word, and the power of the Holy Spirit.

Please enable JavaScript in your browser to complete this form.

Name *

First

Last

Date of Birth

Where are you from?

Gender

• Male
• Female

Phone Number

Email *

Are you a member of BOCHM? *

• YES
• NO

Are you born again? *

• YES
• NO

Are Confidentiality born

Are you baptized? *

• YES
• NO

Have you taken discipleship class? *

• YES
• NO

Briefly describe why you are seeking Inner Healing?

What church are you attending?

Have you participated in Inner Healing or Counseling? *

• Yes
• No

If yes, describe.

Emergency ContactName: Email: Phone:

Confidentiality Agreement *

• Agree

We are committed to keeping everything shared during the inner healing process private and confidential. However, if there is disclosure of harm to yourself or others, or in cases of abuse, we are legally and ethically required to report it to the appropriate authorities.

Consent and Release *

• Agree

By signing below, you acknowledge that you are voluntarily participating in inner healing ministry. You understand that this ministry is a form of pastoral care and not professional counseling or medical treatment. You release the church and its leaders from liability related to your participation.

Submit