GAM Counsel Request Form

A wise man is strong; yea, a man of knowledge increases strength. For by wise counsel, thou shalt make thy war: and in a multitude of counsellors, there is safety. (Proverbs 24:5&6)

Name

First

Last

Phone

Email

Date / Time

Date

Time

Gender

What category does your need for counsel fall under?

Other (Specify Here)

Would you like to give more details? (COUNSELING HISTORY)

Have you had previous counseling?

If yes in above, when?

Where?

4. Give details about the counselling session (What transpired, and how it helped or worsened your situation)

5. If (3) above were with GAM, please give your Counselling Database Registration Number.