Your Contact Information




Person Being Referred






Years Old





Small Group Information


SOS

The following section will be helpful for determining the counselee's SOS:

  • Severity - how complex and urgent is the situation?
  • Ownership - how teachable is the counselee?
  • Support - how well and in what ways can the small group help the counselee?

The following ranges will help clarify the next step for the counselee. Please remember, these are merely a guide and need to be adjusted on a case-by-case basis.

  • 3-9 Care for in the small group; possibly consult someone
  • 10-21 Consult; possibly Biblical Soul Care referral for formal counseling
  • 22-30 Refer to Pastor/Director/Elder/Biblical Soul Care for formal counseling








History







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Spouse's Referral






Years Old





Small Group Information


SOS

The following section will be helpful for determining the counselee's SOS:

  • Severity - how complex and urgent is the situation?
  • Ownership - how teachable is the counselee?
  • Support - how well and in what ways can the small group help the counselee?

The following ranges will help clarify the next step for the counselee. Please remember, these are merely a guide and need to be adjusted on a case-by-case basis.

  • 3-9 Care for in the small group; possibly consult someone
  • 10-21 Consult; possibly Biblical Soul Care referral for formal counseling
  • 22-30 Refer to Pastor/Director/Elder/Biblical Soul Care for formal counseling








History







max 2000 characters


max 2000 characters


max 255 characters


max 2000 characters


max 500 characters


max 2000 characters

Thank you!

Thank you for taking the time to complete the forms. These will be extremely helpful to the Soul Care team in determining what is best for the counselee. Someone from the team will contact you soon for further information and for scheduling an assessment.

We would appreciate prayer for:
  • BSC and others involved to have God's wisdom to accomplish all God is calling them to do.
  • A soft heart for the counselee(s) and a renewed sense of God's presence in his/her life.
  • A blend of truth and grace as counsel is given to the counselee(s).
Note: Click "Save/Continue" to save the referral. Click "Submit" to submit the referral for processing by our staff. Once submitted, you will not be able to edit the referral.