Post Apt Survey

PLEASE COMPLETE THE FOLLOWING QUESTIONS.

Name

First

Last

Mailing Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Active Email

Phone #

Sex

After your freedom appointment, how are you doing in the following areas?

On a scale of 1 to 10, rate yourself in the following areas (1 = No problem, 5 = Moderate problem, 10 = Severe problem):

Who was on your ministry team?

Please include all ministry partner's full names.

How well did our ministry team serve you today?

Were the 7 Steps to Freedom followed in the appointment?

Yes
No
Other

After Care - Are you interested in it? (additional support/activities)

Yes
No

Please share your testimony about your experience with Warriors Set Free.

Can we share your testimony about your experience with Warriors Set Free?

Yes
No

Did you commit or recommit your life to Jesus Christ today?

Commit
Recommit

I understand that the above information will be used for the confidential purposes of the Freedom Apt and under no circumstance will my information be made public. Additionally, I acknowledge that data collected from Freedom Appointments can be used anonymously for analysis purposes to help us better serve future ministry recipients.

Yes