FA – Post Survey

Dear Ministry Recipient,

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


Dean Vander Mey
Executive Director
Set Free

PLEASE COMPLETE THE FOLLOWING QUESTIONS.

Name(Required)
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)(Required)
Anxiety(Required)
Fear (Irrational)(Required)
Anger (Unhealthy)(Required)
Tormenting thoughts and voices(Required)
Habits and/or behavior over which you have little control(Required)
Self Esteem(Required)
Ability to function in daily activities(Required)
Satisfaction in relationships(Required)
Physical Health(Required)
Bible study and prayer(Required)
Reality of God in your life(Required)
Please include all ministry partner’s full names.
Were the 7 Steps to Freedom followed in the appointment?(Required)
Were all 7 steps of your freedom appointment completed today?(Required)
Please select two (2) areas that you felt were most significantly improved today.(Required)
After Care – Are you interested in it? (additional support/activities)(Required)
Did you commit or recommit your life to Jesus Christ today?(Required)
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.(Required)