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BLC Appointment Request Form
Work Entry
Added: 5/2/2024
We are here to support you in your walk with Jesus. No matter what trials you encounter in life, you don't have to go through a them alone. While we are not licensed professional counselors, we can provide Biblical wisdom and insight into the challenges you are facing. You should expect to hear back from someone who will help schedule your appointment within one week. Please fill out this form if you are looking to meet with a pastor or staff member! The best is yet to come!
First Name
First Name is required.
Last Name
Last Name is required.
Phone Number
Phone Number is required.
Email
Email address is not valid
Email is required.
Campus
Morehead
Ashland
Online
Never Attended
Campus is required.
Meeting Topic
Anxiety/Depression
Marriage/Relationship
Parenting
Assistance Paying Bills
Financial Assistance
Work/School
Pornography/Sex
Substance Abuse
Spiritual
Other
Meeting Topic is required.
In order to serve you best, please provide some background details about your situation.
In order to serve you best, please provide some background details about your situation. is required.
Will someone be attending with you?
Spouse
Parent
Friend
I'll be attending by myself
Will someone be attending with you? is required.
Preferred day of meeting
Monday
Tuesday
Wednesday
Thursday
Sunday
Preferred day of meeting is required.
Preferred time of meeting
Morning
Lunch
Afternoon
Other
Preferred time of meeting is required.
How would you prefer to meet?
In-person (preferred)
Online (via Zoom)
First Available
Preferred meeting place is required.
Submit