Prayer & Deliverance Diagnostic Form

Blessings! Before I pray or speak into your situation, I need to understand what you're facing so I can discern the root issue, give you accurate prophetic guidance, and help you find the right solution. Please take a moment to answer these questions truthfully and completely. Your answers will remain strictly confidential.

Please Fill In Your Details Below

1. Your Details

Full Name

First

Last

(This helps us intercede for you specifically.)

Gender

Age

(Knowing your age helps us identify if the issue is linked to certain life seasons or age-based curses.)

🌍 Country of Residence:

(To help us align with your timezone and tailor appropriate support.)

Phone

If you need an appointment for someone under 18, please provide your own contact details.

Email Address

Email

Confirm Email

If you need an appointment for someone under 18, please provide your own contact details.

2. Deliverance Appointment Details

How soon do you need to speak to Master Prophet

4. 💬 What is the specific issue you're asking prayer for?

5. 💔 How long have you been facing this issue?

6. 🧬 Has anyone in your family faced something similar (parents, siblings, etc.)?

Yes
No

(This helps identify if this is a generational or inherited problem.)

7. 🔍 Have you seen anything strange in dreams or around you?

Yes
No

(e.g. snakes, shadows, night attacks, being chased, people sleeping with you in dreams)

8. 🌑 Have you had any of these strange experiences or dreams recently?

2. Here dreams

if Yes please Explain In Details

9. 🔗 Have you ever been involved in or exposed to:

Witchdoctors or herbalists?
Psychics, tarot readings, or horoscopes?
Rituals or spiritual cleansings?
Taken charms or spiritual items from unknown sources?

(If yes, briefly explain what happened. No judgment – we just need to identify spiritual doors.)

11. 💔 Have you experienced any of the following?

Explain It Here In Details

12. 🗣️ Do you hear voices, feel unseen presences, or experience tormenting thoughts?

✔️ (Tick all that apply)

Voices
Feel unseen presences
Tormenting thoughts

13. 🔥 Would you be open to:

1-on-1 Prophetic Deliverance Coaching
Joining a group deliverance session
Learning how to break curses and spiritual attacks
Receiving a customized plan to get free and stay free

1. Your Details

2. Deliverance Appointment Details

12. 🗣️ Do you hear voices, feel unseen presences, or experience tormenting thoughts?

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