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Admin & Info
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Feedback Letter

Dear Ministry Recipient,

Thank you for allowing FDF to disciple you. We welcome your feedback. Please take a moment to let us know how we're doing.

Samuel J Stitt, IV
Executive Director
Fighting Diamond Foundation

PLEASE COMPLETE THE FOLLOWING QUESTIONS.

Name *

First

Last

After your freedom appointment, how are you doing in the following areas?
On a scale of 1 to 10, rate yourself in the following areas (1 = No problem, 5 = Moderate problem, 10 = Severe problem):

Depression (Hopelessness) *

1
2
3
4
5
6
7
8
9
10

Anxiety *

1
2
3
4
5
6
7
8
9
10

Fear (Irrational) *

1
2
3
4
5
6
7
8
9
10

Anger (Unhealthy) *

1
2
3
4
5
6
7
8
9
10

Tormenting thoughts and voices *

1
2
3
4
5
6
7
8
9
10

Habits and/or behavior over which you have little control *

1
2
3
4
5
6
7
8
9
10

Self Esteem *

1
2
3
4
5
6
7
8
9
10

Ability to function in daily activities *

1
2
3
4
5
6
7
8
9
10

Satisfaction in relationships *

1
2
3
4
5
6
7
8
9
10

Physical Health *

1
2
3
4
5
6
7
8
9
10

Bible study and prayer *

1
2
3
4
5
6
7
8
9
10

Reality of God in your life *

1
2
3
4
5
6
7
8
9
10

Who was on your ministry team?

Please include all ministry partner's full names.

How well did our ministry team serve you today? *

Were the 7 Steps to Freedom followed in the appointment? *

Yes
No
Other

Were all 7 steps of your freedom appointment completed today? *

Yes
No

Please select two (2) areas that you felt were most significantly improved today. *

Depression
Anxiety
Fear
Anger
Tormenting thoughts & voices
Habits and/or behavior
Self Esteem
Ability to function in daily activities
Satisfaction in relationships
Physical health
Bible study and prayer
Reality of God in your life

After Care - Are you interested in it? (additional support/activities) *

Yes
No

Please share a personal testimony about your freedom appointment. *

Did you commit or recommit your life to Jesus Christ today? *

Yes
No

I understand that the above information will be used for the confidential purposes of the Freedom Apt and under no circumstance will my information be made public. Additionally, I acknowledge that data collected from Freedom Appointments can be used anonymously for analysis purposes to help us better serve future ministry recipients. *

Yes

SF Bug

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