Common use of Religion Clause in Contracts

Religion. □ None □ Christian □ Jewish □ Muslim □Agnostic □ Other Denominational preference Church attending Member? □ Yes □No Church Address Phone( ) Pastor’s Name Please describe your religious upbringing? Do you believe in God? □ Yes □ No □ Uncertain Why? How often do you pray to God? □ Daily □ Weekly □ Occasionally □ Never How often do you read or study the Bible? □ Daily □ Weekly □ Occasionally □ Never Would you say you are a Christian, not a Christian, or perhaps in the process of becoming a Christian? Do you believe that when you die, you will be with God eternally? □ Yes □ No □ Uncertain Why? Have you been baptized? □ Yes □ No Explain any recent significant changes in your religious life What is your opinion of the Bible? □ I don’t know enough about the Bible to have an opinion. □ It is a book that contains helpful principles that I am free to follow or disregard as I think best. □ It is a book that was inspired by God and that contains helpful principles and instructions I should follow unless I believe there is a good reason to do otherwise. □ It is a book that was inspired by God and that contains helpful principles, instructions, and commands that I should follow regardless of my feelings or preferences. □ Other: Who, if anyone, has the most influence on your religious or spiritual life? (please list their names and their relationship to you) Have you had any menstrual difficulties? □ Yes □ No If yes, please explain Is your husband in favor of your coming for counseling? □ Yes □ No If no, please explain Abortion Divorce Loneliness Adultery Drug abuse Lust Anger Drunkenness Marriage Anxiety (worry) Eating habits Memory Apathy Envy (jealousy) Menopause Appetite Fear Moodiness Bitterness (resentment) Finances Past memories Change in lifestyle Grief Perfectionism Children Guilt Physical abuse Communication Health Pornography Conflict (fights) Homosexuality Rebellion Deception/lying Impotence Sex Decision making Infertility Sexual abuse Dating/courtship In-laws Singleness Depression Laziness Suicide