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"Restoring the Human Heart for the Glory of God"


Online Counseling Service
"I will remove the heart of stone from your flesh
 and give you a heart of flesh." Ez. 36:26

Welcome to Heart Cry Ministries' E-counseling service. Read the following explanations of the serivce, andthen fill out and submit the E-counseling form provided below.

E-counseling Form
First Name

Last Name
Address
   City

State/Providence
  
Zip Code

Email

Gender
Age

If you are comfortable, please check the allowing that apply to your situation:

Sexual Abuse Physical Abuse
Emotional Abuse Depression
Suicide Attempts Suicide Thoughts
Bipolar Personality Anger & Rage
Emotional Dependency Mental Illness
Alcohol Addiction Drug Addiction
Perfectionism Sexual Addiction
Other:


Describe any other experiences in your past that will help explain your present situation.

Describe what you have done in the past and the present to address the area of concern:

 

Describe your present concern:

 

Copyright© 2000 by Roger Hornbeck, all rights reserved