Confidential Personal Inventory

Release of Liability for Whole Soul Ministry, Paula Finch and Team Members for Providing Ministry

I acknowledge that Paula Finch and other team members for Whole Soul Ministry have voluntarily agreed to pray for me. I understand that this session is not a professional counseling meeting and that none of the team members are licensed counselors. I understand that these team members are, to the best of their ability, doing what they can to help me achieve more freedom in my life.

I understand that Whole Soul Ministry (WSM)) does not charge for its services. I further state that I have voluntarily sought assistance of my own initiative and that I am under no obligation to accept or reject any of the advice or help that I might receive from the team members of this ministry. All guidance, counsel, and advice that I receive will be based on Scriptural principles and Christian biblical standards as spelled out in the Holy Bible, the written Word of God. I further understand and acknowledge that all ministry is under the direction and control of the Holy Spirit and that no guarantees are made, nor can be made, with regard to my healing and/or freedom. .

I understand that if I receive ministry from Whole Soul Ministry, Paula Finch and WSM team, the team is committed to respect the disclosed information, but not to complete confidentiality. The information, as needed, may be shared anonymously with other leaders of WSM to further train leaders. .

I agree to hold WSM, Paula Finch, and all other team members free from any and all liability, loss, or damage of any kind that may arise as a result of assistance or ministry which I have received or from my involvement with WSM.

I have read this disclaimer and release of liability. I understand and agree with it and have executed it as a free and voluntary act on my part.

Signature

Date

Phone

Recommended Donation Guidelines
Ministry is free but donations are appreciated. Donations can be made via check, PayPal to [email protected], CashApp to $Finch357 or Venmo to @paulafinch.

General information about receiving ministry

As you share your heart on the following pages, we assure you of confidentiality. Please be certain that you have read and understood the liability release on the previous page. Let us know if you have any concerns regarding the privacy of your information.

This ministry cannot be reduced to a formula by which you know that healing is complete. It is rare to heal all broken parts of a person in one ministry session. This is usually because our hearts are not always emotionally ready to deal with every issue that caused a break. Please understand that some degree of follow-up may be needed within weeks or months after completing the first round of ministry to ensure complete healing.

A word about medication: Parts are typically found through our emotions. Some medications can pacify emotions enough to cause some parts to remain unfound until the medication has ceased. Consult your doctor before altering or stopping your medication for your ministry appointment. Stay in touch with your doctor if you alter usage of medication for ministry. Ministry and medical care are and should be managed as separate, non-interchangeable services. We do not provide advice concerning medical care.

Filling out the Confidential Personal Inventory Form

The purpose of this form is to provide a profile of areas of your life in which emotional and spiritual strongholds may have been formed. This requires your complete honesty. Please be assured that you cannot tell us anything that will cause us to think less of you, scorn you, or look down upon you in any way. Honesty endears us to our ministry recipients. When we see problems and struggles, we rejoice in the opportunity people will have to experience God’s wonderful blessings as they are set free from these same problems and struggles.

As you fill out the form, please:

Pray before and during your work on the form.
Be thorough but we will cover details during your sessions. If we are missing important information, the freedom process can be made much more difficult, or even fail.
Read the instructions for each step carefully.
Provide the year (or your age) for all significant events that you describe.
• Tell us your story. At the end of the form, there is free space for you to write in your own words. Feel free to send us a Word document or email in place of this. It is not uncommon for people’s stories to provide us with as much or more useful information than the inventory form itself!

About the major events of your life that caused you hurt, difficulties, trauma, or great disappointment.

How these events made you think and feel about yourself.

How old you were when each event occurred.

How you feel about yourself now, and why you are seeking freedom ministry.

Remember, more information is better. However, don’t stress about getting all the details down. If in doubt about whether you should include something, please do.

This form must be brought to your first ministry session or you can mail the form to 2745 Collins Drive, Conway, AR 72034 or provide us with a very legible scanned copy via email to [email protected] We reserve the right to reschedule appointments when forms are incomplete or not brought to the scheduled session.

Call or email us if you have questions: [email protected], 501-428-3943

CONFIDENTIAL PERSONAL INVENTORY

PERSONAL INFORMATION

Name

First Middle Last

Date of Birth

Place of birth

City State / Province / Region

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Referred by:

Church Affiliation: Present and Past

Vocation

Employment

Education: Highest completed and degree/diploma received

Please list the names and ages of your siblings

Marital status:

Spouse's name

Date of marriage

Number of times divorced (if any):

Please list full name/s of ex-spouse(s), date of marriage and divorce:

Children’s names and birth dates; indicate if adopted

Do you have any outstanding felonies/warrants for your arrest?

VIDEO MINISTRY INFORMATION

1. If receiving ministry via the internet instead of in person, what video service do you prefer?

2. What ID do you use with your video service?

REASON(S) FOR SEEKING MINISTRY

1. What kind of struggles motivated you to seek ministry?

2. Are there some personal behaviors that particularly trouble you? If yes, please describe:

3. What kind of ministry, mental health, and/or medicinal help have you sought in the past? Did it help? If so, how?

4. Do you feel that there are “different parts” of you that pull you in different directions, want different things in life, etc.?

5. Do you experience periods of intense emotions or obsessions that can take over your behavior or mood? If yes, please describe:

SALVATION

1. If you were to die today, do you have any doubt about where you would spend eternity? If yes, explain:

2. When did you receive Christ as Savior?

3. Describe your salvation experience:

4. Are you trusting in anything other than the shed blood of Jesus alone for your salvation?

5. Do you struggle with doubts about your eternal security? If yes, explain

6. What religion or denomination were you raised in?

7. Describe the religious atmosphere of the home where you grew up:

IDENTITY

1. What do you really think about yourself?

2. What do you really believe other people think about you?

3. What do you really believe God thinks about you?

RELATIONSHIP WITH GOD

4. Do you feel that God is withholding blessings from you?

2. Are you angry at God? If yes, explain:

3. Do have trust issues with God? If yes, explain:

4. Do you feel that God is withholding blessings from you?

5. Why does God love you?

6. Do you read the Bible regularly? If yes, where, when, and to what extent?

7. Do you find prayer time with God difficult mentally? If yes, please explain:

8. Do have trouble hearing God speak to you? If yes, please explain:

9. While attending church or other Christian ministries and functions, are you plagued with foul thoughts, jealousies, or other mental harassments? If yes, please explain:

CHILDHOOD

1. Were you conceived out of wedlock?

2. Are you adopted?

3. To your knowledge, was there any trouble bonding with your mother at birth? Explain:

4. To your knowledge, did you have a difficult, complicated, or traumatic birth? If yes, explain:

5. In whose home(s) were you raised?

6. Are your parents presently married or divorced? Briefly explain the attitude of their relationship:

7. Were your parents emotionally distant with you in your childhood? In your adolescence?

8. Did you experience night terrors as a child? If yes, beginning at what age: Please describe:

9. Were your parents physically, emotionally, or sexually abusive to you or your siblings? If yes, please explain:

10. Were there any events in your childhood that were particularly upsetting or traumatic for you? If yes, please describe:

11. How do/did your parents treat each other?

12. Would you consider either of your parents to be perfectionists? Did they seek perfectionism from you?

13. Describe your relationship with your father:

14. Describe your relationship with your mother:

15. Did your parents treat you significantly worse than your siblings or heavily favor other siblings over you? If yes, please explain

16. Were you raised in a Christian home?

RELATIONSHIP WITH SPOUSE/CHILDREN

If you are not married, please skip this section.

1. If married, do you love your spouse?

2. Please share how you get along with your spouse:

3. Is your spouse a Christian?

4. Please describe your relationship with your children:

ADDICTIONS

1. Are there any addictive problems in your family (alcohol, drugs, etc.)? If yes, please explain

2. Have you ever utilized hallucinogenic drugs? For how long?

Did you have any out-of-body experiences?

Were you addicted?

What treatments did you receive?

3. Are you presently struggling with an addiction? Describe:

4. Have you overcome a past addiction? Describe:

5. Do you have any addictions or cravings that you find difficult to control (tobacco, drugs, alcohol, sweets, food in general, etc.)? If yes, please explain:

6. Do you struggle with modern idolatry (i.e., materialism, being a workaholic, sports addict, addiction to any consuming lifestyle or interest that deters you from God’s will)? If yes, please explain:

MENTAL & EMOTIONAL HEALTH

1. Is there any history of mental illness in your family (including depression)?

2. Do you have any history of cutting or self-mutilation? At what ages:

3. Are you presently taking medication for physical and/or psychological reasons? If yes, please list each medication and explain its purpose:

4. Do you have trouble sleeping? Are you having nightmares or disturbances? If yes, please explain

5. Do you have trouble giving and receiving love?

6. Have you ever thought that perhaps you were "cracking up," "going crazy"? If yes, have you feared “cracking up” or "going crazy" recently? Please explain:

7. Have you ever been diagnosed with any emotional and behavioral disorders?

If yes, please list the clinical terms and your age when each was diagnosed:

8. Have you ever had psychiatric counseling: If yes, were you hospitalized?

If yes, for how long? How did the hospitalization affect you? ever had psychiatric counseling: If yes, were you hospitalized?

Did you have any particularly troubling experiences in the hospital? If yes, please describe:

9. Have you ever heard voices or emotional messages in your mind, had repeating and nagging thoughts that were foreign to what you believe, or felt like there was a dialogue going on in your head? If yes, please explain:

10. Have you ever attempted suicide? If yes, how many times? At what ages? By what method and why?

11. Do you suffer from lapses of memory or time in your day-to-day life? If yes, please explain:

17. Please state below under “Earliest Age,” the earliest age you remember strong, prolonged fear to any of the following, and make an X under “Present” if you still do:

Failure

Earliest Age

Present

Authority figures

Earliest Age

Present

Rape

Earliest Age

Present

Satan and evil spirits

Earliest Age

Present

Insanity

Earliest Age

Present

Opinions of people

Earliest Age

Present

Enclosed spaces

Earliest Age

Present

Open spaces

Earliest Age

Present

Crossing bridges

Earliest Age

Present

Insects

Earliest Age

Present

Snakes

Earliest Age

Present

Pain

Earliest Age

Present

Being alone

Earliest Age

Present

Water/swimming

Earliest Age

Present

Women

Earliest Age

Present

Men

Earliest Age

Present

Flying in an airplane/etc

Earliest Age

Present

Inability to cope

Earliest Age

Present

The dark

Earliest Age

Present

Violence

Earliest Age

Present

The future

Earliest Age

Present

Public speaking

Earliest Age

Present

Old age

Earliest Age

Present

Terminal illnesses

Earliest Age

Present

Spiders

Earliest Age

Present

Animals

Earliest Age

Present

Loud noises

Earliest Age

Present

Grocery stores/malls

Earliest Age

Present

Death

Earliest Age

Present

Death or injury of loved one

Earliest Age

Present

Accidents

Earliest Age

Present

Divorce or marriage break-up

Earliest Age

Present

Other

Earliest Age

Present

RELIGIOUS CULT HISTORY

1. Are/were your parents or grandparents superstitious? Are you superstitious?

2. Were your parents, grandparents, or other close relatives, pastors, or family friends involved occult organizations? If yes, please explain:

What level were they in their organization(s)?

Did any of these people have unsupervised access to you during your childhood years?

3. Did you experience unexplained or supernatural events as a child such as seeing unexplained shadows in your room, hearing footsteps when no one was there, seeing demons, seeing angels, seeing Jesus, levitation, etc.? If yes, please explain:

Do any of those experiences continue today?

4. Have you ever had out of body experiences that were not drug-induced? If yes, explain:

5. Please mark any activities below that you or your relatives have ever been involved in. Initial where applicable with: S = Self, F = Family member.

Freemasonry

Eastern Star

Daughters of Eastern Star

Job’s Daughters

Boys Order of DeMolay

Shriners

Rainbow Girls

Moose Lodge

Elks Lodge

Ouija board

Satanism

Theosophical Society

Witchcraft

Fortune-telling

Tarot cards

Palm-reading

Black or White Magic

Automatic writing

Table-lifting/Light as a feather

Bloody Mary

Light as a feather

Druids

Rosicrucian

Zen Buddhism

Hare Krishna

Mormonism

Jehovah’s Witness

Unification Church

Christian Science

Scientology

Unitarianism

Astrology

New Age

Islam

H.W. Armstrong (World Wide Church of God)

Astral projection

Seance

Dowsing/Water witching

Yoga

List any others you know of:

6. Is there any Masonic or occult regalia or memorabilia in your possession? If yes, describe

7. Have you ever been hypnotized, attended a "New Age" seminar, or participated in a séance, or been through a Native American ceremony? If yes, please explain:

8. Have you ever learned about or used any form of mind communication or mind control? If yes, explain:

9. Have you ever taken a class or read books on parapsychology or witchcraft? If yes, please explain:

10. Do you have, or have you ever had, an imaginary friend or spirit guide offering you guidance or companionship? If yes, please explain:

11. Have you experienced unexplained supernatural events of any kind? Describe:

12. Do you have missing periods of memory from your childhood? During approximately what years are your memories missing?

13. Have you ever made a pact with the Devil? Was it a blood pact? If either of your answers is “yes,” please explain:

ABUSE & SEXUAL HISTORY

1. Have you ever been emotionally, spiritually, and/or physically battered/abused (excluding sexual abuse)? If yes, please explain:

2. Did you experience any type of sexual desire or activity (including masturbation) in very early childhood?

3. Were you sexually promiscuous as a teenager?

4. Tell us about any incidents of molestation or rape, including incest. in your life or the life of your siblings:

5. Is there any other information regarding your sexual history that you believe would help us minister to you?

6. Do you believe you are sexually addicted?

7. Have you ever had an abortion? If yes, please tell how many and at what ages:

8. How did the abortion affect you?

9. Are you active in or addicted to pornography? If yes, what is the earliest age you remember pursuing it? How were you introduced to pornography:

10. Have you ever had homosexual or lesbian thoughts and desires? Do you currently entertain those thoughts?

LIES ABOUT SELF AND NEGATIVE MINDSETS

Check each statement that describes your thinking about yourself

I am all alone.

I don't matter.

God has forsaken me.

I cannot trust anyone.

No one will believe me.

I have been overlooked.

No one ever cares.

There is no one to protect me.

I'm afraid they won't come back.

They do not need me.

They are not coming back.

I am stupid, ignorant, an idiot.

I was a participant.

I should have done something to have stopped it from happening.

I knew what was going to happen, yet I stayed away.

I felt pleasure so I must have wanted it.

It happened because of my looks, my gender, my body, etc.

I did not try to run away.

I was paid for service rendered.

I was bad, dirty, shameful, sick, and nasty.

I allowed it.

I should have known better.

It was my fault.

I should have told someone.

I was a participant.

I should have stopped them.

I am cheap like a slut.

I deserved it.

I did it to him/her first.

I am going to die.

I do not know what to do.

If I trust, I will die.

It is just a matter of time before it happens again.

If I let him/her/them into my life, they will hurt me too.

Something bad will happen if I tell, stop it, confront it.

He/she is going to hurt me.

If I tell they will come back and hurt me.

He/she/they are coming back.

They are going to get me.

He/she/they are too strong to resist.

I am going to die and I cannot do anything about it.

I am too weak to resist.

I cannot get away.

I am overwhelmed.

Everything is out of control.

Not even God can help me.

I cannot stop this.

There is no way out.

The pain is too great to bear.

I cannot get loose.

I don't know what to do

I am pulled from every direction.

I am too small to do anything.

I am dirty, evil, shameful, perverted, because of what happened to me.

No one will be able to really love me.

Everyone can see my shame-filled dirtiness, etc.

I will always be hurt/damaged/broken because of what has happened.

God could never want me after what has happened to me.

My life is ruined.

I will never be happy.

I will always be unclean, filthy, etc.

My body parts are dirty.

I will never feel clean again.

I am not loved, needed, cared for, or important.

I am worthless and have no value.

I was a mistake.

I was never liked by them, because I was _______________!

I could never jump high enough to please him/her.

I could never be as _________________ as he/she.

They do not need me.

I am unimportant.

I should have never been born.

God could never love me or accept me.

I am not acceptable.

I am in the way. I am a burden.

It is never going to get any better.

It will just happen again and again.

I have no reason to live.

I just want to die.

I don't know what is happening to me.

This does not make any sense.

There is no way out.

There is no good thing for me.

There are no options for me.

Nothing good will ever come of this.

Everything is confusing.

Why would they do this to me?

INNER VOWS

Please check anything in the list below that reflects a spoken or unspoken mindset, statement, or attitude that you feel characterized your thinking at any time past or present.

Please tell us about any other key events that may have had a negative or traumatic effect on your life.

You can type in the box provided or you can upload a document below.
All information is kept confidential according to the liability release.

Age: What happened and how it affected you:

Document Upload

Accepted file types: jpg, pdf, , Max. file size: 128 MB.