Financial Healing Please enable JavaScript in your browser to complete this form.Name *FirstLastDISCLAIMER: Your information and data collected will be held in strict confidence. Your name will not be openly shared or connected with any of your responses, nor will we identify you with your responses to third parties without your consent. Please refer to https://prfinstitute.org/privacy-policy/ for further details.Email *EmailConfirm EmailZip Code *Are you an active member of a church or other religious organization? *YesNoD1. Age Range18 to 2425 to 3435 to 4445 to 5455 to 6465 to 7474+D2. Race/Ethnicity *Black/African-AmericanWhite/CaucasianHispanic/LatinoAsianNative AmericanPrefer not to answerD3. Marital status (as of today) *Single (never married)MarriedDivorcedDivorced and Re-marriedWidowedSeparatedPrefer not to answerD4. Number of children (or dependents) *This is to help us measure how many persons within a family unit that we could potentially assist. Enter N/A if you prefer not to answer.D5. Employment status (primary) *EmployedUnemployedRetiredSelf-employedMilitaryStudentOtherPrefer not to answerD6. GenderMaleFemale#1: All of the healings in the Bible were focused on physical and mental situations. *TrueFalse#2: I believe there are many people within the church(es) or communities that could use a financial healing? *DisagreeAgreeStrongly Agree#3: Many people want God to heal them, but are not willing to put in the work? *DisagreeAgreeStrongly Agree#4: People suffer financially because they have not made the necessary changes to their situation(s). *DisagreeAgreeStrongly Agree#5: Have you felt stressed over any of these life situations within the last 3 years? *Medical debtUnemploymentUnderemploymentDivorceEmergency situationsBad creditDeath of spouse or partnerN/AOther#6: If I do not receive a financial miracle soon, I will be in a very bad place. *DisagreeAgreeStrongly Agree#7: People, even in my circle, really do not know the [unpleasant] financial situation I am in. *TrueFalseN/A - I am not in an unpleasant place financially.#8: I have access to the tools for my financial situation to improve. I just need someone to show me how to use them. *TrueFalse#9: Economic relief efforts should be led primarily by *the church.the government.family members.the local community.None of the aboveOtherPlease select no more than two (2) options.#10: The process of healing requires _____ solutions. *short termlong termboth short and long termEmailSubmit
