SCHM’s Intake Form is a Personal History Questionnaire.  The information you provide allows the prayer ministers to review your history and reasons for coming for prayer.  All the information you share with us is held in strict confidence.  Your Intake Form will be returned to you at your first appointment.  Please bring with you for any future appointments.

Download both PDF forms

For Mac users you will need to install Adobe Acrobat, click on button above and then click “open in”  Acrobat to open the fillable form.

   

Click on form below to switch between pages on the screen. Page selection is on bottom of form.