Osborne Baptist Church

Personal Counseling

Complete this private form to request personal biblical counseling through Osborne Baptist Church.

This form is not monitored for emergencies. If anyone is in immediate danger or needs urgent crisis help, contact emergency services or a local crisis service now.

Osborne Baptist Church Biblical Counseling Information Form

Name

First Name Last Name

Parent/Guardian Name (If Applicable)

First Name Last Name

Email Phone Our counseling team will use this number to text or call you within 5–7 days. Age

Gender

Male Female

Are you currently seeing a counselor?

Yes No

Have you been charged with a sex crime?

Yes No

If you answered YES, we are still available for counseling. We will designate a different location other than the church to accommodate you.

Presenting Issue: Why do you want to meet with a counselor? Additional Comments