mcr – Threshing House

Counselling With EEO

Personal Information

First Name *

Last Name *

Age *

Email Address *

Address(City and Country)

Marital Status *

WhatsApp Contact *

Religion

Emergency Contact

Full Name *

Relationship *

Phone Number *

Session Preference

Counseling Type *

Session Format *

If Premarital, Duration of Courtship

If Marital, How Many Years Married

Frequency *

Counseling Information

Describe the Issue *

Consent & Confirmation

I confirm that all information provided is accurate.

I understand that submitting this form does not automatically guarantee a counseling session.

For Couple Sessions: I confirm that my partner is aware that this counseling session is being booked.

For Couple Sessions: I confirm that my partner has consented to participate in counseling.

This counselling service is faith-based, with all discussions grounded in the principles and values of the Christian faith.