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Schedule an Exorcism

To schedule an exorcism with us, please fill out the below form. Upon completing this form you will be sent an email with instructions on how to complete your registration and schedule your session. If you do not receive a confirmation email please make sure to check your spam filter and if it is not there then reach out to us here.

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Private and Confidential 

This Profile is copyrighted and may not be reproduced in any form without the written permission of Bob Larson and the Spiritual Freedom Church International, Inc. © Bob Larson 2017 

All information supplied in this form is voluntarily given. The respondent has the right to refuse answering any questions and such refusal will not prejudice the interpretation of the information supplied. 

Client Profile Form
Gender Required
Salvation/Christian Confession Required
Marital Status Required

Spiritual Information

Describe Your Relationship w/ God? Required

Family History

Describe your relationship with your parents, stepparents, siblings when you were a child. 

Spiritual Evaluation: Occult Practices

Please check the box of each item you have participated with or in.

Occult Practices Required

Spiritual Evaluation: New Age/Psychic Practices

Please check the box of each item you have participated with or in.

New Age Practices Required

Religious Literature

Please check the box of each item you have read, studied, or been in agreement with.

Religious Literature Required

Religious Beliefs, Cults, & Secret Societies

Please check the box of each item you have participated with or in.

Religious Beliefs Required

Physical Health Issues

Please check the box of each physical health issue you struggle with.

Physcal Health Issues Required

Mental Health Profile

Please check the box of each mental health issue you struggle with.

Mental Health Issues Required

Emotional/Behavioral Profile

Please check the box of each item that applies to you.

Emotional Health Issues Required
Anger Issues Required
Abberational Behavior Required
Criminal Activity Required
Death Issues Required
Addictons Required

Sexual History

Please check any box that applies to you.

Sexual Activity Required

Trauma/Abuse

List any episodes of abuse, trauma, major accidents, or any other events that deeply affected you

Demonic Activity & Manifestations

Please check the box of each item that applies to you.

Demonic Activity Required
Demonic Manifestations Required
Abnormal Demonic Activity Required
Demonic Manifestations (cont.) Required
Are You Hearing Any Voices or Having Any Thoughts That: Required
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