SPIRITUAL DIRECTION QUESTIONAIRE

To make the best use of our time together, please fill out this spiritual direction in marriage and family questionnaire Form completely. It would help set the agenda for your spiritual direction in marriage and family session. It also helps me to be as prepared as possible. Please electronically fill this form and SUBMIT to me at lease 24hrs prior to first session. This spiritual direction in marriage and family / spiritual direction questionares are only filled out before the first session. Your information is held in strict confidence.

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Telephone (home)

Home

Telephone (office)

Phone *

Email *

Date of birth *//

Occupation *

Marital Status *

No. of children

Selected Value: 1

If Any

Religious Affiliation

Place of worship

Please feel free to complete your responses

1. Do you think that our modern society has departed from the biblical understanding of marriage as described in Genesis 2:24? *

Yes
No

2. Do you think the government should promote laws that encourage the biblical understanding of marriage and family? *

Yes
No

3. Should your state or local government have legislative power to impose upon families and marriages - God’s intention for marriage and family as seen in creation? *

Yes
No

4. How much involvement do you think that the local government should have in such matters?

Strong
Weak
None

In one week

5. Do you believe that sin brought a reversal of male – female roles in marriage and family? *

Yes
No

6. Should a father exercise his responsibility as head of the home?

Yes
No

In one week

7. If you are a mother / wife - do you apply the Bible teachings on your responsibilities as mother /wife? *

Yes
No

8. How would you describe your family/ marriage? Is it an ideal one? *

Yes
No

9. Is your marriage/ family characterized as ideal? *

Yes
No

10. Do you think God has an opinion in your marriage/ family? *

Yes
No

11. Do you believe that a family that prays together - stays together? *

Yes
No

12. Has your marriage/ family got a relationship with God? *

Yes
No

13. Do you experience God daily in your marriage and family? *

Yes
No

14. What are you currently using as a basis for your prayer? How often do you take time for family prayer? How long are your prayer times? *

5 minutes
30 minutes
60 minutes or more

15. Do you hope to gain from spiritual direction? *

Yes
No

16. What days/times are more convenient for you to meet with a spiritual director? *

Days
Evenings
Weekends

16. What led you to seek spiritual direction at this time?

Signature

Welcome back,