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Van Wyk
The Ministry of Healing
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First Name
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Age
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Relationship
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Divorced how many?
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Mother's ethnic history
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Religion
Read bible daily
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Attend Church
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Parents
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Father relationship
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Conceived before marriage
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Who had the authority
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Parents encourage you?
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When converted
Baptised
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Prayer
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See God as loving Father
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Mother relationship
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A planned child
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Parents affectionate to each other
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Were you a happy child
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Past religion
Filled with Holy Spirit
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Connecting socially
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Were your parents
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Siblings relationship
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The sex they wanted
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Affectionate to you?
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Childhood missing memory
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Family history: Nightmares, occult interest, health issues, addictions, mental illness, secrets.
Witchcraft and the Occult
Astral Travel
Automatic writing
Fortune Tellers
Astrology
Channeling
Incantations
Ouji board
Seances
Dowsing
Tarot cards
Table lifting
Light as a feather
Witchcraft
Spells
Blood pacts
Oaths
Palm reading
Questionable Gaming
Black Magic
White magic
Details:
New Age Practise
Auras
Firewalking
Psychic healing
Spirit guides
Past life therapy
Ascended masters
Meditation
Hypnosis
Clairvoyance
Parapsychology
Remote viewing
Tantric yoga
Telekinesis
Psychokinesis
Angel guides
Reiki
Mind control
Telepathy
Levitation
Mobile phone
Trances
Transendental meditation
Psychadelics
Kundalini yoga
Details:
Participation in or drawn to?
Agnosticism
Atheism
Bahai
Brujeria
Church of Satan
Demolay
Eastern star
Eckankar
Freemasonry
Hare Krishna
Hinduism
Islam
jehovah witness
Ku Kux Klan
Kabbalah
Mormonism
Neo Nazism
Neo Paganism
Odinism
Paganism
Reincarnation
Rosicrucianism
Rainbow girls
Santeria
Scientology
Christian science
Science of Mind
Theosophy
Temple of Satan
Taoism
Buddhism
Voodoo
Additional information relating to above choices
Mental Health Check
ADD/ADHD
Anxiety
Autism
Bipolar
Borderline
Depression
MPD/DID
OCD
Panic attacks
Phobias
Psychosis
Schizophrenia
Other disorders
Physical Health check
Arthritis
Cancer
Chronic fatigue
Diabetes
Epilepsy
Fibromyalgia
Gastro issues
Heart disease
Infertility
Insomnia
Migraines
Miscarriages
PTSD
Thyroid disorders
Autoimmune diseases
Additional information
Do you suffer with:
Guilt
Shame
Condemnation
Unforgivable
Remorse
Inferiority
Insecurity
Worthless
Low self-esteem
No identity
No purpose
Do you suffer with:
Forgetfullness
Unresolved grief
Jealousy
Suspicion
Unrelenting fear
War/death trauma
Loss of time
Act like a child
Unrelenting stress
Sleep paralysis
No attraction to spouse
Do you suffer with:
Self revenge
Self hate
Self vows
Rage
Anger
Resentment
Bitterness
Hate others
Hate government
Bullied others
Cruelty
Do you suffer with:
Hate God
Unforgiveness
Physically abused
Physical abuser
Emotionally abused
Emotional abuser
Spite
Frustration
Revenge
Extra information
Addictions
Alcohol
Gaming
Gambling
Workaholic
Prescription drugs
Sleeping pills
Tobacco
Drugs
Food
Sex
Mobile phone
Gossip/slander
Irrational behaviour
Anxiety attacks
Tourette's syndrone
Picking/tics
Anorexia/Bulimia
Shoplifting/spending
Undiagnosable sicknesses
Relative information:
Death Issues
Self-harm/cutting
Self-harm thoughts
Suicide attempts
Suicidal thoughts
Intent to harm others
Murder
Morning after pill
Abortion
Blood pact
Criminal activity
Drug seller
Embezzelment
Arrested
Imprisoned
Stealing
Rape
Theft
Violence
Weapons obsession
Sexual history
adultery
Beastiality
Gay/Lesbian
Internet/phone sex
Incest
Lustful thoughts
Masturbation
Molested
Molested someone
Necrophilia
Perverted sex
Promiscuity
Prostitution
Pornography
Rape
Sadomasochsim
Stripper
Transvestism
Victim of rape
Additional related to above:
Demonic activity
Antichrist sentiment
Blasphemous thoughts
Bad friendships
Deny Jesus as God
Desire to renounce God
Deny existence of Satan and demons
Desire to curse God and Christ
Family curses
Hostile to the Church
Hostility to God
Pact with the Devil
Extra information
Demonic manifestations
Alien abduction
Change in voice texture
Clawing inside you
Confused thoughts
Convulsions, seizures, or twitches
Defile holy objects
Feel eerie presence
Fear of holy water
Foam at the mouth
Fear of annointing oil
Hear voices or hissing sounds
Hear voices of dead people
Hear unusual sounds
Inability to move or speak
Near death experience
Obscene , uncontrollable outbursts
Possessed by a living person
Poltergeists
Psychic abilities
Sudden mood changes
Out of body experience
Sudden sleepiness
See demons
See monsters
See nature spirits
Spirit possession
See ghosts or apparitions
See visions
Smell strange odours
See dark figures or shadows
See fairies, goblins, barbs, gremlins
Unknown languages spoken
UFO sightings
Inability to pray
Inability to read the bible
Unexplained accidents
Unusual strength
Additional information related to above:
Abnormal demonic activity
Altered states of consiousness without alcohol or drugs
Feeling cold or having the room become cold
Feel like an external force has power over you
Feel like you are in a heavy mist or force
Feelings of pressure or suffocation on your chest
Feelings of being choked when praying
Feelings like you are possessed by a dead person
Fear, mocking or revulsion towards sermons, music or symbols
Unexplained electronic or mechanical equipment malfunction
or physical attacks on your body
Having feelings of being controlled by something outside of yourself
Hearing growling sounds inside your head or body
Hearing voices or thoughts that:
Are strong urges to commit suicide, homicide, murder or abortion
Blaspheme God, Jesus or the Holy spirit
Condemn you constantly
Urge you to commit illegal, immoral or destructive activities
Urge you to commit perverse sexual acts or harm others sexually
Explain in more detail:
Denial function and blocks
Do you blame others for your problems?
Do you daydream to escape your problems?
Do you wish you were someone else?
Do you check out emotionally when problems come?
Do you realise when your behaviour is bad?
Do you take out your anger on people who havent hurt you?
List of medications:
Have you had psychiatric help, if so was there a diagnosis?
Have you had shock treatment?
List any struggles from 0 years to now that you feel is important:
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