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Pastor/Key Leader Survey
(At present this is a passive survey meant to be copied and used outside of this site.)
Administration options:
1. Print out copy to be filled in, then mailed or faxed.
2. (ctrl C) Copy and paste to your personal e-mail. After pasting, respond to each catagory then send.
3. Copy for personal use with staff & leadership.
Directions:
Place an (X) next to the item that you often encounter pertaining to your membership/community.
Place two (XX) next to the items that are significant trouble areas in which you would like to be able to better respond.
Issue Regular Contact Significant Issue: Need Personal Issue:
With This Issue Referral or Expertise Self/Peer/Family
__________________________________________________________________________________________________________________
Area 1-Abortion
___________________________________________________________________________________________________________________
Area 2-ADHD
___________________________________________________________________________________________________________________
Area 3-Alcohol/Drug Addiction
___________________________________________________________________________________________________________________
Area 4-Anger
___________________________________________________________________________________________________________________
Area 5-Anorexia & Bulimia
___________________________________________________________________________________________________________________
Area 6-Bipolar Disorder
___________________________________________________________________________________________________________________
Area 7-Blended Families
___________________________________________________________________________________________________________________
Area 8-Boundries
___________________________________________________________________________________________________________________
Area 9-Career Decisions
___________________________________________________________________________________________________________________
Area 10-Child Sexual Abuse
___________________________________________________________________________________________________________________
Area 11-Childhood Trauma
___________________________________________________________________________________________________________________
Area 12-Chronic Illness
___________________________________________________________________________________________________________________
Area 13-Codependency
___________________________________________________________________________________________________________________
Area 14-Communication
___________________________________________________________________________________________________________________
Area 15-Conflict Resolution
___________________________________________________________________________________________________________________
Area 16-Cults
___________________________________________________________________________________________________________________
Area 17-Decision Making
___________________________________________________________________________________________________________________
Area 18-Depression
___________________________________________________________________________________________________________________
Area 19-Divorce
___________________________________________________________________________________________________________________
Area 20-Dysfunctional Family
___________________________________________________________________________________________________________________
Area 21-Employment
___________________________________________________________________________________________________________________
Area 22-Fears & Phobias
___________________________________________________________________________________________________________________
Area 23-Financial Struggles
___________________________________________________________________________________________________________________
Area 24-Forgiveness
___________________________________________________________________________________________________________________
Area 25-Gambling
___________________________________________________________________________________________________________________
Area 26-Gender Issues
___________________________________________________________________________________________________________________
Area 27-Grief
___________________________________________________________________________________________________________________
Area 28-Guilt
___________________________________________________________________________________________________________________
Area 29-High Maintenance Folks
___________________________________________________________________________________________________________________
Area 30-Homosexuality
___________________________________________________________________________________________________________________
Area 31-Infertility
___________________________________________________________________________________________________________________
Area 32-Loneliness
___________________________________________________________________________________________________________________
Area 33-Marriage Choices
___________________________________________________________________________________________________________________
Area 34-Overeating
___________________________________________________________________________________________________________________
Area 35-Parenting
___________________________________________________________________________________________________________________
Area 36-Perfectionism
___________________________________________________________________________________________________________________
Area 37-Pornography
___________________________________________________________________________________________________________________
Area 38-Pregnancy, Unplanned
___________________________________________________________________________________________________________________
Area 39-Premarital Counseling
___________________________________________________________________________________________________________________
Area 40-Purpose In Life
___________________________________________________________________________________________________________________
Area 41-Self Worth
___________________________________________________________________________________________________________________
Area 42-Sexual Addiction
___________________________________________________________________________________________________________________
Area 43-Sex In Marriage
___________________________________________________________________________________________________________________
Area 44-Singleness
___________________________________________________________________________________________________________________
Area 45-Single Parenting
___________________________________________________________________________________________________________________
Area 46-Spouse Abuse
___________________________________________________________________________________________________________________
Area 47-Stress
___________________________________________________________________________________________________________________
Area 48-Suicide/Prevention
___________________________________________________________________________________________________________________
Area 49-Terminal Illness
___________________________________________________________________________________________________________________
Area 50-Time Management
___________________________________________________________________________________________________________________
Area 51-Unequally Yoked Mate
___________________________________________________________________________________________________________________
Area 52-Workaholism
___________________________________________________________________________________________________________________
Area 53-Worry
___________________________________________________________________________________________________________________
Area 54- _________________
___________________________________________________________________________________________________________________
Area 55- _________________
___________________________________________________________________________________________________________________
Area 56-_________________
___________________________________________________________________________________________________________________
Area 57-_________________
___________________________________________________________________________________________________________________
Area 58-_________________
___________________________________________________________________________________________________________________
(At present this is a passive survey meant to be copied and used outside of this site.)
Administration options:
1. Print out copy to be filled in, then mailed or faxed.
2. (ctrl C) Copy and paste to your personal e-mail. After pasting, respond to each catagory then send.
3. Copy for personal use with staff & leadership.
Directions:
Place an (X) next to the item that you often encounter pertaining to your membership/community.
Place two (XX) next to the items that are significant trouble areas in which you would like to be able to better respond.
Issue Regular Contact Significant Issue: Need Personal Issue:
With This Issue Referral or Expertise Self/Peer/Family
__________________________________________________________________________________________________________________
Area 1-Abortion
___________________________________________________________________________________________________________________
Area 2-ADHD
___________________________________________________________________________________________________________________
Area 3-Alcohol/Drug Addiction
___________________________________________________________________________________________________________________
Area 4-Anger
___________________________________________________________________________________________________________________
Area 5-Anorexia & Bulimia
___________________________________________________________________________________________________________________
Area 6-Bipolar Disorder
___________________________________________________________________________________________________________________
Area 7-Blended Families
___________________________________________________________________________________________________________________
Area 8-Boundries
___________________________________________________________________________________________________________________
Area 9-Career Decisions
___________________________________________________________________________________________________________________
Area 10-Child Sexual Abuse
___________________________________________________________________________________________________________________
Area 11-Childhood Trauma
___________________________________________________________________________________________________________________
Area 12-Chronic Illness
___________________________________________________________________________________________________________________
Area 13-Codependency
___________________________________________________________________________________________________________________
Area 14-Communication
___________________________________________________________________________________________________________________
Area 15-Conflict Resolution
___________________________________________________________________________________________________________________
Area 16-Cults
___________________________________________________________________________________________________________________
Area 17-Decision Making
___________________________________________________________________________________________________________________
Area 18-Depression
___________________________________________________________________________________________________________________
Area 19-Divorce
___________________________________________________________________________________________________________________
Area 20-Dysfunctional Family
___________________________________________________________________________________________________________________
Area 21-Employment
___________________________________________________________________________________________________________________
Area 22-Fears & Phobias
___________________________________________________________________________________________________________________
Area 23-Financial Struggles
___________________________________________________________________________________________________________________
Area 24-Forgiveness
___________________________________________________________________________________________________________________
Area 25-Gambling
___________________________________________________________________________________________________________________
Area 26-Gender Issues
___________________________________________________________________________________________________________________
Area 27-Grief
___________________________________________________________________________________________________________________
Area 28-Guilt
___________________________________________________________________________________________________________________
Area 29-High Maintenance Folks
___________________________________________________________________________________________________________________
Area 30-Homosexuality
___________________________________________________________________________________________________________________
Area 31-Infertility
___________________________________________________________________________________________________________________
Area 32-Loneliness
___________________________________________________________________________________________________________________
Area 33-Marriage Choices
___________________________________________________________________________________________________________________
Area 34-Overeating
___________________________________________________________________________________________________________________
Area 35-Parenting
___________________________________________________________________________________________________________________
Area 36-Perfectionism
___________________________________________________________________________________________________________________
Area 37-Pornography
___________________________________________________________________________________________________________________
Area 38-Pregnancy, Unplanned
___________________________________________________________________________________________________________________
Area 39-Premarital Counseling
___________________________________________________________________________________________________________________
Area 40-Purpose In Life
___________________________________________________________________________________________________________________
Area 41-Self Worth
___________________________________________________________________________________________________________________
Area 42-Sexual Addiction
___________________________________________________________________________________________________________________
Area 43-Sex In Marriage
___________________________________________________________________________________________________________________
Area 44-Singleness
___________________________________________________________________________________________________________________
Area 45-Single Parenting
___________________________________________________________________________________________________________________
Area 46-Spouse Abuse
___________________________________________________________________________________________________________________
Area 47-Stress
___________________________________________________________________________________________________________________
Area 48-Suicide/Prevention
___________________________________________________________________________________________________________________
Area 49-Terminal Illness
___________________________________________________________________________________________________________________
Area 50-Time Management
___________________________________________________________________________________________________________________
Area 51-Unequally Yoked Mate
___________________________________________________________________________________________________________________
Area 52-Workaholism
___________________________________________________________________________________________________________________
Area 53-Worry
___________________________________________________________________________________________________________________
Area 54- _________________
___________________________________________________________________________________________________________________
Area 55- _________________
___________________________________________________________________________________________________________________
Area 56-_________________
___________________________________________________________________________________________________________________
Area 57-_________________
___________________________________________________________________________________________________________________
Area 58-_________________
___________________________________________________________________________________________________________________