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Pastoral CounselingMinistry
Attn: Intake Personnel
11905Highway 92
Woodstock, GA 30188
DearApplicant,
Thank you for your interest in pre-marital counselingat First Baptist Church of Woodstock. Our desire
is to help you preparefor, and establishthe strongestmarriagepossibleto the glory of God.
to assistyou in this process. Pleasemaketwo
With this in mind,we offer Biblical premaritalcounselingsessions
copiesof this document(onefor eachof you), carefullyreview,completeand signthe attachedCONFIDENTIAL
have been returnedto the
PremaritalCounselingQuestionnaire.When both of your completedquestionnaires
you
not heardfrom us in a
If
have
your
appointment.
you
weekday
to
schedule
aboveaddress,someonewill call
anytime.
time, pleasecall the office phonenumberat770'591-4770
reasonable
During your initial pre-marital assessmentappointment,the processof pre-marital counseling will be
discussedwith you. If your wedding is scheduledin one of our buildings and/or officiated by one of our
ministers, pleaseknow that it is the church's policy that the pre-marital counseling processbe completed
prior to your wedding. Pleaseallow at leastten weeksfor the counselingprocessto be completed.
process is completed,
After the Bibticat basisfor the marriage is determinedand the initial assessment
you con proceed with reserving a datefor your wedding on the church calendar.
We lookforward to receiving your completedquestionnaireand movingforward with your pre-marital
counselingprocess.
Until then,maythe Lord blessyou andyour family.
Sincerely,
@ir6arttrt
,/a,nte,,'s
Rev. JamesEubanks
Director of PastoralCounselingMinistry
First Baptist Church of Woodstock
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PASTORAL C OUNSELING MINISTRY
of First Baptist Church Woodstock
Premarital Ouestionnaire
Welcome to the Pastoral Counseling Ministry of First Baptist Chuch Woodstock - where we
seek to offer Biblically-based, Christ-centeredcounseling. We know that choosing your life
partner is the secondmost important decision of your life. Our church desiresto assist every
couple in this decision by providing premarital counseling and preparation. The Pastoral
Counseling Ministry of First Baptist Church Woodstock (FBCW) offers premarital counseling
to couples who are mernbersof FBCW desiring Biblically based instruction and preparation
for marriage or for those who are being married in our facility. Couples who are not FCW
membersmay also receive premarital counseling,schedulepermitting.
Lay counselors: Your premarital counseling sessionsmay be provided by a trained lay counselor. Lay counselors
work under the supervision of staff counselors. Staff counselors are either licensed professional counselors or
certified pastoral counselorswith formal training.
Qualifications of Lay Counselors: Becauseof the Biblical and spiritual nature of this ministry, we train our own
volunteers for the ministry of lay counseling. Lay counselorshave received training through our Lay Coimseling
Training Program in listening and helping skills, and the application of BiblicaVspiritual principles to the issuesof
marriage. Lay counselorsdo not possessprofessionallicensesor certifications issuedby the Stateof Georgia for the
practice of professional counseling,marriage and family therapy, or social work specialties;nor do they necessarily
possessthe required education, experienceor training for such licenses. Referral options to outside professional
providers are available upon requestifneeded.
The premarital counseling we provide is faith-based and spiritual in nature. Georgia law prohibits compelled
disclosure of these counseling exchanges,notes or records in any court of law. Accordingly, our counseling team
will not provide court testimony and by signing below you are acknowledging this strict confidentiality and further
agree that neither you nor your legal representativewill attempt to subpoena your counselor for testimony.
Furthermore, we do not render any financial, legal or medical opinions and/or advice.
Limitations of Confidentiality: The content of your sessionsare confidential except in caseswhere it is necessary
to report the suspicion ofchild abuse,threatsto harm selfor others,or to receive supervision.Lay counselorswork
under the supervision of the staff counselors in the Pastoral Counseling Ministry. Staff counselors fiinction as a
team and utilize peer supervision on an ongoing basis to provide the highest quality of care. The counseling
ministry will need to consult with the wedding coordination staff and the ministerial staff for the purpose of
providing approvals for a couple to be married at FBCW or by an FBCW minister.
Resolution of Disagreements: If a dispute should arise between a person receiving ministry and the premarital
counselor (andlor the Church) regarding the premarital counseling sessionor the premarital counselor's advice or
conduct, one should bring this dispute to the attention of the Director of the Pastoral Counseling Ministry. If the
dispute cannot be resolved at this level, all parties agree to resolve such dispute by submitting to the Church's
Executive Senior Staff Team for fulI and final resolution and conciliation.
Waiver of Liability: ln considerationfor receiving any form of premarital counselingfrom the PastoralCounseling
Ministry of FBCW, the person receiving the counselingagreesto releaseand waive any and all claims of any kind
against the ministry, the staff, the premarital counselor(s)or the Church, which may arise from, result out of, or be
related to conduct or advice siven.
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Counseling Files: A1l counselingfiles and their contentsbelong to the FBCW PastoralCounseling Ministry.
Donations to Ministry: This ministry is made possible by the tithes and offerings of the members of First Baptist
Church Woodstock. If you are not a consistent contributor to FBCW we ask you to help support this ministry,
based upon your abilities, through donations while you are receiving counseling.Pleasemake your checks payable
to First Baptist Church Woodstock. There are no fees for your premarital counseling sessions,however, there are
fees for certain assessmentinventories that may be used.
Availability and Cancellations: Our ministry is available only on an appointment basis. Sessionsare only held
during office hours. We often carry afi extensive waiting list. Therefore, if you need to reschedule or cancel an
appointment,we ask that you call at least 24 hours in advance. This allows us to rescheduleothers who are on our
waiting list.
Homework: Be advised that your premarital counselor will likely assign homework. Homework is a vital part of
the preparation process;therefore, completion of the homework assignmentsbefore your next sessionis expected.
Your premarital counselor may require the use of an excellent workbook, "Before I Do" by K. Jason Krefsky as
part of your preparation. These workbooks are available from the Pastoral Counseling Ministry or from
www. FulI MarriageExperience.com.
I have carefully read this information sheetand agreeto all of the statedterms and conditions.
Name (printed)
Date
Signature
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PersonalData
Groom
Bride
Name:
Name:
Address:
Address:
Cttylstatelzip:
Citylstatelzip.
E-Mail:
E-Mail:
Hm. Phone:
Hm. Phone:
Wk. Phone:
Wk. Phone:
Cell Phone:
Cell Phone:
Member FBCW Y e s I
Birth date
NoI
Member FBCW
Birth date
Age:
I
Yes
!
NoI
I
Age:
Where will the weddine be held?
Approx. Date of your wedding:
Name of the Pastorwho will perform the ceremony.
Yourcurrentmaritalstatus:Single-Divorcedwidowed
Fianc6'scurrentmarital status: Single
Divorced
Widowed
Best Time for Premarital Appointment
I
!
I
T
Anytlme9 am- 5 pm, Monday,Tuesday,Thursday
Rnytime9 am- 6 pm Wednesday
is thebesthour
is thebestday
We will attempt to accommodatethesetimes as our availability allows.
The greater flexibility you can have with your schedulemay allow for quicker placement.
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Premarital Questionnaire
1. Describe your current spiritual status.
2. If you have come to place of knowing JesusChrist as your Lord and Savior, pleaseshareyour
testimony on a separatesheetof paper.
3. Describe your understandingof your fianc6's current spiritual status.
4. Have you ever been divorced?
divorce on a separatesheetofpaper.
If so, pleasedescribethe circumstancessurroundingthe
5. How long have you and your fianc6 known eachother?
How did you and your fianc6 meet?
6. How long have you been engaged? How well do you believe you know your fianc6?
7.Havetherebeenanybreakupsduringthetimeyouweredatingorengaged?-Ifso,describe
how you resolved the issuessurroundingthe breakup?
8. Do your immediatefamily members(parents,siblings,or children)give their full supportto your
In what ways are they showing or voicing their support?
intentionsto marry?
9. Do your closestfriendsgive their full supportto your intentionsto marry?
arethey showingor voicingtheir support?
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In what ways
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10. As a result of being in this relationship,do you find yourselfwalking closerwith the Lord, or is your
Pleaseexplain your answerin the space
spiritual life being hamperedin any way?
provided.
11. Are you or your fianc6 bringing any children into this marriage?
children saying about having a new stepparent?
If so. what are the
12. Describe your relationship with your fianc6's immediate family (parents,siblings, or children).
13. Describe how you and your fianc6 have handled conflict betweeneachother.
14. Describe any concernsthat you might have about your fianc6's words, attitudesor behaviors in the
midst of conflict.
15. Are you and your fianc6 currently, or have you ever been,living together?
Premarital counselingwill involve discussionswith all couplesabout the importance of sexual purity
and practical helps in achieving and/or maintaining purity before marriage.
16. Have you an your fianc6 disclosedall aspectsof your financial statusto each other, including credit
Describehow well you understandyour fianc6's financial
card debits,loan balances,etc.?status.
17. Are there any health concernsof physical conditions that might hinder your functioning in the
If so, have you discussedtheseconcernswith your ftanc6?
marriage?
i8. Are there any emotional traumasor psychological concernsthat might hinder your functioning in the
If so, have you discussedtheseconcernswith your fianc6?
marriage?
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19. Is the use/abuseofalcohol or substances
an issueor concernfor eitheryourselfor your fianc6?
Ifso, describehow you and your fianc6have resolvedtheseconcerns.
20. To what degreehave you and your fianc6 discussedyour plans, hopes and dreamsfor the fufure? How
confident are you that you both are headingin the samedirection in life?
21. List what you seeas your fianc6's three greatestcharacterstrengths?
22.List what you seeas your fianc6's three greatestcharacterweaknesses?
23. Are you preparedto acceptyour fianc6,just as they are, (without trying to changethem) for the rest of
your life?
24.Is there anything about this relationship that is causingyou to have secondthoughts about a lifetime
commitment to them?
25. Is thereanyotherinformationto sharethatmaymakeyour premaritalcounselingprocessbeneficial?
I havecompletedthis questionnaire
thoroughlyandaccuratelyandIrealize thatmy premaritalcounselor
will wantto havefollow-updiscussions
aboutmanyof thesequestions.
Signed
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