LIBERATION CARD NEW JERUSALEM BAPTIST CHURCH

Ministry of Spiritual Warfare Gaditas Generation

LIBERATION RECORD
LOCAL OF THE ADMINISTRATION: _______________________________________________________________DATE: ___/___/_____

FILL IN WITH ALL SINCERITY AND DO NOT HIDE ANYTHING, SO THAT YOUR LIBERATION IS COMPLETE! THIS FORM WILL BE TOTALLY
CONFIDENTIAL. ONLY FILL OUT THIS QUESTIONNAIRE IF YOU WANT TO BE MINISTERED. IN THE FRAMEWORK, ONLY CHECK WHAT
IS STILL HAPPENING CURRENTLY IN YOUR LIFE. IN THE OTHER SECTIONS, MARK THE OCCURRENCES THROUGHOUT YOUR LIFE THAT NEVER
IF THEY HAVE BEEN RENOUNCED, IF NECESSARY, WRITE OTHER INFORMATION ON THE BACK OF THE PAGE.

I- NOME: _________________________________________________ SEXO: ____ DATANASC.: ___/___/___ Nº DEFILHOS: ____

ESTADOCIVIL: SINGLE; LEGALLY MARRIED; DIVORCED DISREPECTFUL TOO MUCH WIDOWER; SEPARATED
END.: ________________________________________BAIRRO: _____________________ CIDADE: _________________UF: ___
CEP: __________-_____ TEL.: (___) _____________ E-MAIL: ____________________ CÔNJUGE: ________________________
GRAUESCOLARIDADE: _________ PROFISSÃO: __________________________ É CRISTÃO? YES:___YEARS AND___MONTHS; NO
É BATIZADO? ______ IGREJA A QUE PERTENCE: _________________________________ PASTOR: ____________________________
SEU CARGO NAIGREJA: ___________________ POSSUI DONS ESPIRITUAIS? ______ QUAIS? __________________________________
WHAT IS YOUR MAIN PROBLEM? ____________________________________________________________________________
______________________________________________________________________________________________________
HAS IT BEEN PERSONALLY DELIVERED? _____ BY WHOM? ______________________________________________________________
DID YOU ENCOUNTER ANY UGLY DISCUSSION IN THE LAST 24 HOURS? _____ WITH WHO? ____________________________________________
ESTÁ EM TRATAMENTO MÉDICO? ______ TOMA ALGUM MEDICAMENTO? _______ PARA: ________________________________________
Are you fasting? CAN YOU KEEP UP WITH THE STUDIES? WHEN YOU READ THE BIBLE: GIVE SLEEP; VAGUEIA

II - RELIGIONS AND SECTS HE/SHE PRACTICED OR WITH WHOM HE/SHE ENGAGED:

CATHOLICISM SPIRITISM Candomblé UMBANDA QUIMBANDA
Buddhism SEICHO-NO-IÊ SHINTOISM Mahikari MAGIANEGRA
Islamism Hinduism TAOISM Tantrism CATIMBÓ
Messianic HARE KRISHNA UNIFICATION ANIMISM REORDER
MORMONS ATHEISM BOYS FROM GOD Scientology CANJERÊ
[Link]Á Rosicrucian Christian Rationalism LEGION OF GOODWILL candle
CHRISTIAN SCIENCE Masonry SANTODAIME PERFECT FREEDOM OMOLOCÓ
BAAÍSMO DAVIDA TREE (I. LOC.) SATANISM WICCA OTHERS:

III - ACTIVITIES AND TREATMENTS YOU HAVE ALREADY DONE OR WITH WHOM YOU GOT INVOLVED:
POWER OF THE MIND PARAPSYCHOLOGY VIOLENT VIDEO GAMES HYPNOSIS DEBACH FLOWERS
PYRAMIDS Pro-Life POKÉMONS HARRY POTTER REGRESSION
HOMEOPATHY ACTION - LIFE CHROMOTHERAPY LOGOSOPHY
DO– ÍN
CRYSTALS SILVAMIND [Link] ACUPRESSURE Mineryotherapy
NOVAERA MINDPOWER EUBIOSIS GNOSE ACUPUNCTURE

UFology THEOSOPHY DAWN VALLEY Aromatherapy DRUGS(DEP)

CHACRAS MEDT. TRANSCENDENTAL TUNING Tai Chi Chuan PROJECTOLOGY
MENTAL RELAXATION YOGA RPG CAPOEIRA MARTIALARTS:
REIKI

IV – FEELINGS, ATTITUDES, VICES AND ACTIONS PRESENT IN YOUR LIFE:

DEFEAT FEAR AGGRESSIVENESS malice GREED
SADNESS PANIC VIOLENCE PORNOGRAPHY GAMES OF CHANCE
MELANCHOLY DEPRESSION REVENGE homosexuality LOTTERIES
BLOCKING DESIRE TO DIE IRRITATION LESBIANISM Sofreuperdas
SOLITUDE INSOMNIA DESIRE TO KILL SEXUAL REQUEST SOFREUROUBOS
LIE NIGHTMARES HATE PROBLEMS IN MARRIAGE BANKRUPTCY
ENVY JEALOUSY DESTRUCTION UNCONTROLLED LAUGHTER WITHHOLDING OF THE DIME.
CHORO ANXIETY RANCOR IMPURITY FINANCIAL ISSUE
AUTO REJECTION CONCERN LACK OF FORGIVENESS MASTURBATION DENIAL
GUILT CONFUSION THOUGHTS OF DEATH ALCOHOLISM CONSUMERISM
Bitterness MADNESS FACTIONS gossip GREED
RESENTMENT Nervousness THEFT ROBBERY STILL SMOKE PRIDE N-
INFERIORITY OPPRESSION REBELLION I STILL TAKE DRUGS Incurable disease
FRUSTRATION MANIA OF DISEASES WASTE GLUTTONY LOSS OF ENERGY
Laziness Psychological problems I DON'T HAVE PEACE CURSE WORDS ESCAPE ESP Ion Block
ISOLATION RELIGIOSITY Incredulity LIE INTELLECTUALISM
SHAME Malignant Premonitions Traditionalism FORGETTING RACISM
AUTOCOMMISSIONING I hear strange voices SURPRISE IMAGES PASSIVITY

Counseling Sheet Page. 1

 LIBERATION CARD NEW JERUSALEM BAPTIST CHURCH
Ministry of Spiritual Warfare Generation of Gadites

MURMURS IDOLATRY A:___________ MANIPULATION OF PEOPLE INTOLERANCE PROCRASTINATION

TORMENT COMPULSÃOA:__________ INDIFFERENCE OTHERS: IRA
BRIGAS Suffered an accident

ACCIDENT WITH SEQUELS DEFICIENT BODY PARTS? _______ WHERE? __________.

V – ACTIVITIES IN THE CATHOLIC CHURCH AND VARIOUS PRACTICES:

NOME DAIGREJA: _____________________________________ I am a practitioner IT WAS NOT I WAS BAPTIZED
1A COMUNHÀO CRISM CATECHISM ATTENDED THE MASSES Took Host
I was a father PROCESSIONS LOADED IMAGES LOADED CANDLES USED CROWN
Took holy water FEZ ROMARIA IT'S A NUN DRESSING AS AN ANGEL I was blessed
Ate a little bread, Distant Antônio Received blessing from the Pope It was a little crown
MADE PROMISES FOR: _____________________________ MOTIVO: _______________________________________________________
MARRIED IN THE CATHOLIC CHURCH Voted for: _______________________ CHARISMATIC PART MOVEMENT
SAINTS OF DEVOTION: ________________________________ WAS AAPARECIDA DONORTE? _______ REASON:_______________________
WAS A: ________________________________________ PART OF PARTIES AT THE BEACH FOR YEMANJÁ?______ OFFERED?______________
LIT CANDLES: FOR SOULS FOR THE GUARDIAN ANGEL FOR YOU DE7DIAS FOR ENTITIES
PRAYERS: Hail Mary tray queen Novenas THIRTEEN DAS7VELAS SAINT
CLARA
St. Cruz de Caravaca DALUA STONE St. Mark is Mellow St. Expeditus SÃOCIPRIANO
OTHERS: __________________________________
VENERATED APARECIDA FÁTIMA LOURDESGUADALUPE ROSARY CAACUPE
OTHERS: __________________________________

Feast of Cosmas and Damian PARTICIPATED - ATE AND DRANK:

lollipop TWELVE BALA corn pudding RICE PUDDING CORN BOLO
PEANUT BOLOGNA GROSELHA POP CORN GELATIN MEL MARIA-
MOLE Pudding CHOCOLATE REFRIGERANT SUGAR SIGH
CALLED CHILDREN FOR PARTY Provided food and drinks OTHERS

PARTICIPATED IN REGIONAL AND RELIGIOUS FESTIVALS:

FOLIA DODIVINO FOLIA DEREIS LEAF OF SOULS Cattle Fair thunders
TWO RAMS CIRO DENAZARÉ My Ox HALLOWEEN JUNINAS
DRESS UP AS A GHOST CARNIVAL - WAS: Pajelança OTHERS:

VARIOUS PRACTICES:
- SYMPATHIES: _______________________________________________________________________________________________
- BENZIMENTOS (DESCRIBE HOW IT WAS DONE, IF ANY ENTITY WAS RECEIVED, AND FOR WHAT PURPOSE IT WAS USED) ___________________________________
____________________________________________________________________________________________________________
DO YOU HAVE OR HAD IMAGES OF ANY KIND (SAINTS, STATUES, PAINTINGS, ETC.) WHICH?
HAS OR HELD AMULETS, CHARMERS, TALISMANS, FETISHES:
Horseshoe CRUCIFIX STARFISH SNAILS, SEA SHELLS
SCARAB BAT CRYSTALS Little Saints
SEAHORSES CROSS OF CARAVACA OWL Buddha
PYRAMID FOUR LEAF CLOVER SEMENT DEJERIQUITI LOTUS FLOWER
SWASTIKA FIGA Buzios PEN OPENING
CRUZANSATA RABBIT'S FOOT ANCHOR

USED COLORFUL STRIPS USED CORDS WITH SHELLS: (DESCRIBE THE COLOR AND WHERE IT WAS USED)______________________
HOROSCOPE: consulted AS OFTEN AS I COULD DO NOT LEAVE HOME WITHOUT DOING IT STUDIED ASTROLOGY
YOUR SIGN WAS:__________
CONSULTED: ASTRO MAP Palm Reading (Chiromancy) DECARTAS DEBT
CRYSTAL BALL COMRUNAS
OTHERS:___________________________________________________ WATER BASIN READING OF CLOUDS
NUMEROLOGY COMBUSTIONS Ouija (Board)
HAVE MYSTICAL EXPERIENCES: WITH CUPS Comtesoura CABALA
WITH MIRROR COMPENDIUM COM: ________________________________________
OTHERS: ____________________________________________________________________________________________________
HAVE YOU EVER THOUGHT ABOUT
SUICIDE
SUICIDE
ATTEMPT: MENTION THE METHODS:___________________________________________________
___________________________________________________________________________________________________________
DID YOU WISH FOR SOMEONE'S DEATH? WHO AND WHY?
HAVE YOU FORGIVEN THESE PEOPLE?
HAVE YOU EVER HAD AN ABORTION? HOW MANY?I CONSENTED FOR MY PARTNER TO PRACTICE.

Counseling Sheet Page. 2

 LIBERATION FORM NEW JERUSALEM BAPTIST CHURCH
Ministry of Spiritual Warfare Gadita Generation

YOU "ENJOYED" MOVIES: OF TERROR OF VIOLENCE

VI- SUPERNATURAL ABILITIES DEVELOPED:

DIVINATION PRESENTIMENTS OF ACCIDENTS AND DEATHS (PREMONITION) TELEPATHY

MANIPULATION OF PEOPLE VISION OF SHADOWS PERCEPTION OF NOISES IN THE HOUSE (FURNITURE, CUTLERY, STEPS)
CURE USE OF THE POWER OF THE MINDVOICE AUDITION CRAVING FOR STRANGE THINGS
Psychography LEVITATION CONTRACTING VISION OF SPIRITS
FEELING OF BEING FOLLOWED VUD MAGIC POWER TO MOVE OBJECTS
HYPNOTISM OUT-OF-BODY TRAVELS MENTALIZATION Witchcraft
OTHER: ________________________________________________________________________________________________

VII- CURSES:

DO YOU OBSERVE IN YOURSELF AND IN YOUR FAMILY SOME SYMPTOMS OF FAMILY CURSE? YES NO
WHICH?
INDICATE THE RELIGION OF YOUR PARENTS AND GRANDPARENTS (LIST ALL THAT THEY PRACTICED, EVEN IF FOR A SHORT TIME):
OF YOUR PAI:____________________________________________________________________________________________________
FROM YOUR PATERNAL GRANDPARENTS: HE________________________________________SHE____________________________________________
{"maternal_grandparents":{"he":"HE________________________________________","she":"SHE____________________________________________"}}
YOU ARE DESCENDANT OF: ON FATHER'S SIDE:_____________________________ON MOTHER'S SIDE_________________________________________
YOUR PARENTS YOUR GRANDPARENTS: THEY WERE NOT LEGALLY MARRIED.
YOUR PARENTS DID YOUR GRANDPARENTS:BLESS?
YOUR PARENTS, OR ANCESTORS CAUSED ABORTIONS. HAVE YOU BEEN CONSECRATED TO ANY SAINT OR ENTITY? WHICH ONE? ____________
_______________________________________________.
SOMEONE DID SPIRITUAL WORK AGAINST YOU, WHO, HOW, AND WHY?____________________________________________________
_______________________________________________.
SOMEONE WISHED FOR YOUR DEATH, WHO IS IT AND WHY?
_______________________________________________.
SOMEONE CURSED YOU, WHO AND WHY?
_______________________________________________.
YOU KICKED CANDLES IN THE CEMETERY, ON THE STREET, AT THE BEACH,
MEXEUETC. ZOMBOU OF MACUMBA WORKS? Ate or drank something
THEY?
DID YOU EAT SOMETHING GIVEN TO YOU BY A SPIRITIST OR UMBANDIST? WHAT WAS IT?_________________________________________
HAVE YOU RECEIVED ANY GIFT GIVEN BY A SPIRITIST OR UMBANDIST? WHAT WAS IT? _______________________________________________

YOUR HOUSE - THE HOUSE YOU CURRENTLY LIVE IN:

There were old Ubandista inhabitants. IT WAS A TERREIRO OR A SPIRITIST CENTER LOCAL PLACE OF PROSTITUTION
IT WAS A CEMETERY Former residents worked with fortunes (shells, tarot, cards)
WAS THERE SUICIDE OR VIOLENT DEATH IN THE
YOURHOUSE
HOUSE HAS BEEN 'BLESSED': WITH WHAT?
WAS ANY WORK DONE ON IT? ____________________________________________________________________________________

VIII - CONSTANT DREAMS:

PANTHER, TIGER LESMA PRECIPICE CHILDREN LIZARD BLACK WOMAN

DEAD PARENTS CURRENTS DRAGGING FALLING SPIDER WOMAN IN BLUE OR
ANOTHER COLOR

WATER FAT MAN IN ORIENTAL CLOTHES MAN ON THE COVER AMEBA

BLACK MAN FLYING CATHOLIC SAINTS C/FATHER ACCIDENTS
SAPO
SEXUAL REQUEST CEMETERY BEING PURSUED SISTER SERPENT
BUGS
DYING

IX – ENGAGEMENT WITH THE NEW ERA:

NOSTRADAMUS
HAVE YOU ALREADY READ BOOKS BY: PAULO COELHO LAIRRIBEIRO CARMEMBALLESTEROS
SHIRLEYMACLAINE ALICE BAILEY GREGBRODSKY PIERREWEIL RONHUBBARD
OTHERS: ______________________________________________________________________________________________
PARTICIPATED IN TALKS OR SEMINARS WITH: ____________________________________________________
USED: VIDEO TAPES FITAS CASSETES PARTICIPATED IN NEW ERA CONGRESSES
OPENING OF CHAKRAS

X - INVOLVEMENT WITH FREEMASONRY:

Counseling Form Page. 3

 RELEASE SHEET NEW JERUSALEM BAPTIST CHURCH
Ministry of Spiritual Warfare Gadite Generation

PARTICIPATED UP TO GRADE______. ACTIVE; INACTIVE WHEN YOUNG HE PARTICIPATED IN DADEMOLAY RECEIVED THE ADOPTION OF DELOWTON
I AM THE SON OF A MASON I AM A MASON'S GRANDSON I AM A MASON'S WIFE I PARTICIPATED IN WHITE PARTIES

XI – INVOLVEMENT WITH ROSY CROSS:

PARTICIPATED UP TO ______DEGREE. FOR HOW LONG?___________ INSTALOUSANCTUM (AT HOME) FOICOLUMBA

MANTRAS THAT YOU PRACTICED: __________________________________ MENTAL VISUALIZATION AND MEDITATION FOIMATRE
WHITEPARTIES HELD POSITIONS:______________________ PERFORMING HEALINGS I AM THE CARRIER OF ARCHOTE

XII – INVOLVEMENT WITH SEICHO-NO-IÊ

PARTICIPATED FOR HOW LONG: _________________ ONLY READ LITERATURE; LIFT; SOURCE OF LIGHT; Calendar Sutrasagrada
RECEIVED PASSES ATTENDED THE TEMPLE IDOLATRY AMASSAHARUTANIGUCHI ATE CAKES, ETC. INCENSES
EMANTRA PRAYERS: JISSÒEMANKANZEN HIOGUMUGUENKIÓKIÓSHINCHOKAN KORRÔNOÔ OTHERS:
Veneration and prayer to ancestors HELD POSITIONS: HONORED FALSE Buddha SUMIOSCHI Kanzeunbozatsu
GORROZOM

XIII – ENVOLVIMENTO COM O BUDISMO:

PARTICIPATED FOR HOW LONG:____________ THE LITERATURE RECEIVED PASSES Veneration and Prayer to Ancestors HELD POSITIONS
FREQUENTED THE TEMPLE; IDOLATRY TO BUDDHA (SIDDHARTHA GAUTAMA)You are a [Link]ÔRENGUIEKIÔ Amitabha
BONZO INCENSES CHANTS EMANTRAS: DAIMOKO OTHERS_____________________ ATE CAKES, ETC.

XIV - INVOLVEMENT WITH OTHER SECTS (INDICATE IN THE BLANK LINES OTHER ONES YOU WERE INVOLVED WITH)

PASTAS HOW LONG? EMANTRA PRAYERS PRACTICED PRACTICES ENTITIES

Venerated
MESSIANIC MEISHUSAMA
MORMONS MORONI
[Link] OSHIÊOIASAMÁ
PRO - LIFE

XV–DEVELOPMENT IN UMBANDA, CANDOMBLÉ, SPIRITISM, ETC. I NEVER DEVELOPED

WHAT LINES HAVE YOU WORKED WITH:

AFRICANA NAGÊ MALEI MISTA Cablocoquimbandeiro
THE SOULS SKULLS NOSSURUBI Witchcraft WHITE TABLE OTHERS:
DO YOU HAVE YOUR NAME OR PHOTO IN THE CENTER/TEMPLE?
OR THE NAME OF SOMEONE YOU GAVE? WHO? ___________________________________
I HAVE CLOTHES OR OBJECTS OF YOURS IN THE CENTER. NAME(S) OF THE CENTER(S) YOU ATTENDED: __________________________________________________

YOU BECAME:
YAÔ (INITIATION PERIOD) CAMBONA (TAKES CARE OF ALL THE THINGS OF THE SPIRITUAL LEADER)
OGÃ(SING, PULL THE POINTS, TOBAQUE) OVIDANDA (CANDIDATE FOR MUCANDA CANDONGO)
OMOKURIN (SON/DAUGHTER OF A SAINT) ADAUXÉ (REPRESENTS SANHA IN HEALINGS, DEMONSTRATIONS OF STRENGTH, PREPARATION OF RITUAL AMULETS)
YALORIXA (MOTHER OF SAINT) BABALORIXÁ (FATHER OF SAINT) IN THE NORTHEAST, OR BABALAÔ IN BAHIA

SHOWERS TAKEN:
OF HERBS OF FLOWERS OR PETALS PERFUMES 7 LEGUMES 7 VEGETABLES EBÔ
7 FRUITS MARAFO (DRINK) Pemba Powder SMOKE WATER Dew Water Palm oil
OF POPCORN OF WAVES GROSS SALT BLOOD OTHER TYPES OF DRINKS:
OTHER (PLEASE PROVIDE DETAILS ABOUT IT, FOR EXAMPLE, WHICH HERBS, WHICH FLOWERS, ETC.) ___________________________________________

PRACTICED RITUALS:
TOOK PUFFS FROM PIPE, CIGAR, OR CIGARETTE. FROM WHICH ENTITIES?
DRANK FLUID WATER DRANK FOR THE ENTITIES - FOR WHOM? ____________________________________________________
Ate things offered to entities. What did you eat? _________________________________________________________________
FOR WHAT ENTITIES?
CLOSING OF THE BODY GUNPOWDER CIRCLE I load USED NECKLACES TOMOU PASSES SPIRITUAL OPERATION
YOU SMOKED OR DRANK WITH ENTITIES INCORPORATED IN SOMEONE. WHICH ENTITIES?
ENTRUSTED SONGS FOR THE ENTITIES. WHICH?
SPIN FOR INCORPORATION. OF WHICH ENTITIES? __________________________________________________________________________
WAS MEDIUM, HORSE, OR DEVICE OF: __________________________________________________________________________________
ATTACHED (SAINT OF HEAD) ELEDA (SECOND HOLY OF HEAD) IT HAS IMAGES OF: __________________________________________
HEADGEAR SLEPT IN THE SNORE, HOW MANY DAYS? ______________ CORONATION
HEAD STRENGTHENING. WHAT TYPE?
CONFIRMATION OF GUIDES AND PROTECTION. WHAT TYPE? ____________________________________________________________________________

Counseling Record Page. 4

 RELEASE CARDNEW JERUSALEM BAPTIST CHURCH
Ministry of Spiritual Warfare Generation of Gadites

BAPTISM IN THE TERREIRO, OF WHOM?

CONSECRATION OF CHILDREN TO ENTITIES. (ALSO THROUGH PASSES):
FILHOS:________________________________________________ENTIDADES:____________________________________________________
FEZ PEDIDOS A ENTIDADES A FAVOR DE ALGUÉM. PARA QUEM,O QUE PEDIU E A QUE ENTIDADES?___________________________________________
___________________________________________________________________________________________________________________
DID YOU MAKE REQUESTS TO ENTITIES FOR YOUR OWN BENEFIT? WHAT DID YOU REQUEST AND FROM WHICH ENTITIES?
____________________________________________________________________________________________________
ASSEMBLY OF SAINT (ALTAR FOR GUIDE, WHEN IT IS KNOWN THAT IT BELONGS TO HIM) FOR WHICH SAINT?___________________________________
MARKS ON THE BODY. FROM WHAT?_______________________
HAS TATTOOS HEADBUTT IN CONGÁ IN TOMB

OFFERING OF ANIMALS FOR SACRIFICE:

BODE CHICKEN SAPO CAT LIZARD KID DOVE
OTHERS_________________________________________________________FOR WHICH ENTITIES?__________________________
___________________________________________________________________________________________________
OFFERINGS (FOOD, DRINKS, SWEETS, DELICACIES) TO SAINTS. WHAT IS IT FOR AND FOR WHOM?
___________________________________________________________________________________________________
BALÉ (CLOSED RITUAL OF CANDOMBLÉ, WHERE PERVERSIVE SPIRITS ARE LOCKED IN A HOLE, TO DO ONLY EVIL).
QUIBAMBU (PUNISHMENT RITUAL FOR THE SAINT'S CHILD WHEN THEY ERR).
MUCANGACANGOGU (ANNUAL CEREMONY HELD IN DECEMBER FOR OXALÁ, BABÁ–OKÊ WITH SEVERAL DISHES, HEAD BANGING, AND REFERENCES).
BLACK MAGIC SABBT (BLACK MAGIC RITUAL) DEONORIAL RITE (WORST BLACK MAGIC RITUAL)

HELPED OR ASSISTED IN DOING WORK IN THE FOLLOWING PLACES:

(SPECIFY FOR WHAT, FOR WHOM, WHAT WAS USED FOR WHICH ENTITY):

NA MATA AT THE BEACH_______________________ AT THE CROSSROADS

AT THE CEMETERY__________________ THE SWAMP, MUD IN RIVER
IN THE GARDEN____________________ NO ANTHILL ON THE CHARGER
ON THE MOUNTAIN AT HOME_______________________ ABROAD
FEZ VUDU IN THE WHITE GAMELEIRA IN THE CENTER OR TERREIRO________________
ON TOP OF THE STONE ON THE GATE OR GATE OTHERS: ___________________________
WHAT IS OBLIGATION BY QUEORIXÁ OR ENTITY?
DID YOU PAY?

XVI – ENTITIES WITH WHICH IT ENGAGED:

WRITE WHAT TYPE OF CONTACT YOU HAD: IF YOU RECEIVED HER, TOOK A PASS FROM HER, JUST CONVERSATION, DRANK OR SMOKED WITH HER:

DOVE-GIRLS:
MARIAPADILHA MARIARITA FROM THE CROSSROADS LADY OF THE NIGHT MARIACOLODINA
MARIA AMÉLIA Silver Sandal 7SAIAS Mariamulambo
MARIA OF THE FIELDS Sea Calunguinha DACALUNGA MARIAFARRAPO
MARIA DAS GRAÇAS SUSUAJÓ GYPSY Mariaquitéria
MARIA7SAIA Fortune Teller CIGANA DENENGUÊ MARIABUENO
ANOTHER "MARIA" The Worms MALEBARA MARIATONICA
Little Maria Little squawker OTHERS: SEVENTEEN CROSSROADS
QUEEN 7 ROSES ZERO-HOUR MARIAFACEIRA
MARIAMENINA OTHER: __________________________________________________________

EXUS:
EXU-REI Street Crossing THE DARKNESS GATE DORIO
BURNING-PEMBA LUCIFER STREET TRANCA OF SOULS 7CROSSROADS
stump OF THE MUD JOAOCAVEIRA Beelzebub TRANCA-EVERYTHING
7 SCALES TIRIRI CAMPINA little rain MAYORAL
Fé Bridge 7 Swords DASENZALA MOUTH OF FIRE MULAMBINHO
SUPREME TREME-TERRA 7 PAVINGS BRAZIL little grill
TIRIRI-BOY BLACK CAP WORLD TOUR 7 COVAS Saddle
HOSE little turtle PURPLE-CAP VIRA–WORLD 7 DOORS
thug ZÉPILINTRA MOUNTAINS RED-CAP PULLED OUT
7 STAB WOUNDS BLACKSTONE ZÉFERREIRA ZEZINHO BAT
COBRA-CORAL 7 LIRAS HAVE REQUEST ZEPEREIRA Little black one
SKULL SKULLHEAD 7 CATACOMBS ALUVIATE VULTURE
Little João MIDNIGHT SHRIMP 7 WINDOWS RAG
PEPPER TONINHO Black Ash LOBSTER 7 MOUNTAINS

Counseling Form Page. 5

 LIBERATION RECORD NEW JERUSALEM BAPTIST CHURCH
Ministry of Spiritual Battle Gaditas Generation

GYPSY BARALOGI MARABÔ CORCUNDA 7 DUSTS

Lona QUIRIMBÓ THE PAVERS JOHN DACRUZ VELVET
META-META

CABOCLOS
DAMATA SULTÃO DAMATA PENABRANCA GREENPEN IARA
BREAK – DEMAND ERU XOROQUÊ DAGUINÉ White Water
INDIA BREAK - KILL BAIANO TUPINAMBÁ GREEN ARROW (OR OTHER COLOR)
TUPI UBIRATÃ 7 ARROWS UBIRAJARA REDMORRO
Tupiniquim SUNFLOWER 7 STARS TABAJARA BLACK PANTHER
ARARIBÓIA INDIAN 7 QUARRIES HONORINA PINGA–FIRE
SACI CURUPIRA GRAVEL JUPIRA MATAVIRGIN
BUGRE XOROQUE CAIPORA REDPULL JACIRA
JUSSARA JUREMA TUPERI

OTHER ENTITIES:
BAIANO GAUCHO BLACKBERRY WORN OUT UERI
Sailor Cattle drover OLD - ANASTÁCIA BLACKPANTHER LAMPIÃO
MEIOMUNDO DADÁ (OF VEGETABLES) FISHERMAN CAMINALUÁ MAROQUIASINTALAMI
AJÉXAKUNGA (WEALTH) ZULE PAITOMÉ FROM ANGOLA IBEJÉ COSME EDAMIÃO; DOÚN ABUCU;
ALABÁ HUMMINGBIRD; CRISPIM CRISPINIANO UNGE BANKIN). YES(S) VÓJOAQUINA VÓCAMBINDA
ANOTHER GRANDMA: __________________________________________________________

ORISHAS
OGUM OGUMXOROQUE OXOSSE XANGO OSANHI OXUMMARÉ
OMULU OBALUAÊ OXUM Iemanjá NANÃ LOGUMEDÉ
IANSÃ EUÁ OBÁ IROKO OXALUFAN OXOGUIÃN
Orumila ORIXANILÁ OLODUMARÊ OXALÁ (LAGOS)

SPIRITS (WHITE TABLE):

[Link] ANDRÉLUIS DR. BEZERRA DEMENEZES LOAUREANO
DR. MACIEL [Link] DEAD PE. CICERO
DR.________________ Sister Teresa SISTER CLARA DOORIENTE GUIDE
CHILDRENGUIDE Sister Sheila PAIVICENTE JOAN OF ARC
FREIGIOVANNI ANGELS OF LIGHT OTHERS:

EASTERNERS:
Amaterasu KRISHNA Kundalini FALIK
Buddha LILITH BONZO GORROZOM
SHIVA VISHNU Brahma GANESH
ISIS OSIRIS ASTAROTE LEVIATHAN
BAAL MOLOQUE OMITAMA DAGOM

VARIOUS:
SAINTGERMAIN My esteemed master DAMIAM ELMORYA
ANJOMORONI MENGUELESH SERAPISBEY PAISETABRANCA
NOSFERATUS CONFUCIUS PYTHON Arians
HILARIOUS Jugal Beelzebub SAMÁTICO-MARA
NAGÔ DIANA NOTHING LUCIFER
ASMODEUS ROWENA JABULOM MOM
LOVE BAPHOMET APOLION GRANDFATHER
DEVILOCK OTHERS:

XVII - HAVE YOU BEEN A FAN, MADE ANY REQUEST, OR HAD ANY CONTACT WITH:

HAS
GNOMES (IN GREEK MYTHOLOGY THEY ARE DWARFS WHO LIVE IN THE CENTER OF THE EARTH): WE HAVE GIVE THINGS FOR HIM
NYMPHS (DEITY OF RIVERS, SOURCES, FORESTS, AND MOUNTAINS) ONDINES SALAMANDERS (GENIES THAT PRESIDE OVER FIRE)
ELVES (SPIRITS OF THE FOREST) SILFOS (DEITIES THAT PRESIDE OVER THE AIR) ETHEREALS (CREATURES THAT GOVERN THE ETHER)
POKÉMONS:___________________________________JOGOS DERPG: ________________________________________________
HUGGED TREE STAYED UNDER THE PYRAMID MADE A PACT WITH:___________________________________
ROCK BAND:_________________________________________________________________________________________
EXTRATERRESTRIALS: LEU LOOKING FOR CONTACT HE/SHE CONTACTED HAD CONTACT WITH SHIP

Counseling Sheet Page. 6

 LIBERATION FORM NEW JERUSALEM BAPTIST CHURCH
Ministry of Spiritual Warfare Gadita Generation

COSMIC ENERGIES MENTAL ENERGIES WITCHES FADAS MANDALAS

OTHER:_________________________________________________________________________________________________

XVIII - VICES, INVOLVEMENTS AND ACTIONS TAKEN (THROUGHOUT ONE'S LIFE):

(WHEN IT STILL OCCURS CURRENTLY, UNDERLINE THE WORD; WHEN IT OCCURRED ONLY IN THE PAST, SIMPLY MARK THE ITEM)
COMIC)

ALCOHOLISM LIE GAMES OF CHANCEINCEST HOMOSEXUAL CONTACTS ONLY IN CHILDHOOD

Gluttony Malediction THEFTS, ROBBERIESpornography HOMOSEXUALISM/LESBIANISM GREED
I smoke REBELLION CONFLICTS, DISSENSIONS MASTURBATION BESTIALITY (SEX WITH ANIMALS)
SUFFER ROBBERIES DRUGS HEAVY ROCK MURDER PROSTITUTION Fornication (among singles)
Suffer Losses HYPOCHONDRIA GREED ASSAULTS ANAL SEX ADULTERY (BETWEEN
MARRIED
DRESS UP SWEAR WORDS ROGOU PRAGAS HATE RAPED
ABUSED IMPURE DATING

XIX – DISEASES AND SYMPTOMS CURRENTLY SUFFERING

INSOMNIA Fainting and convulsions EPILEPSY IMPRESSIONS OF SWELLING ON THE HEAD

drowsiness
STOMACH PAINS Dysrhythmia SWELLING IMPRESSION ON THE BODY WEIGHT ON THE COLUMN
IN UTERUS/OVARY
ALLERGY Punctures on the body PAIN IN THE SPINE KIDNEYS, URINARY TRACTS HIV
POSITIVE
Numbness in parts of the body SCAM LACK OF AIR EAR PAIN Buzz
CANCER BURNING SENSATION IN THE LEGS
SCHIZOPHRENIA CONSTANT HEADACHE PARKINSON'S DISEASE CHANGE OF VISION
stuttering OBESITY OTHERS:___________________________________

XX – TRAUMAS AND FINAL OBSERVATIONS

DO YOU HAVE ANY CHILDHOOD OR PRE-ADOLESCENCE TRAUMAS - WHICH ONES?

______________________________________________________________________________________________
I WAS SEXUALLY MOLESTED - BY WHOM?___________________________HOW MANY TIMES?_________HOW OLD WERE YOU?________
DID YOU FEEL LONELY: FROM YOUR MOTHER
FROM YOUR FATHER
FELT REJECTED BY:___________________________________________
I AM AN ADOPTED SON YOUR DELIVERY WAS: NORMAL CESARIANA THERE WERE COMPLICATIONS
YOUR PARENTS DID NOT WANT THE PREGNANCY
WE WANTED FROM ANOTHER SEXI WAS PUNISHED EXCESSIVELY I WAS TREATED WITH INJUSTICE BY SOMEONE. WHO?__________________
WHAT ARE YOU AFRAID OF?
ARE THERE PEOPLE WHO HAVE NEVER FORGIVEN? NAME THEM: ____________________________________________________
ARE YOU FULLY SURE OF YOUR SALVATION?___________WHY?_____________________________________________________________
ARE YOU IN SEARCH OF SPIRITUAL GIFTS? _____________ IF SO, WHICH ONES? ____________________________________________________________
COMPLETE WITH ADDITIONAL INFORMATION YOU CONSIDER IMPORTANT. USE THE BACK OR ATTACH ANOTHER SHEET IF NECESSARY.

QUESTIONS

A FACT OR EVENT THAT MARKED YOUR LIFE – OR WORDS SAID BY PARENTS OR SOMEONE THAT STILL HURT?
__________________________________________________________________________________________________________

DO YOU HAVE A WILL TO LIVE?____________WHY?___________________________________________________________________________

FOR ANYTHING, DO YOU BLAME GOD OR JESUS?________WHY?_____________________________________________________
FEEL AN UNCONTROLLABLE SEXUAL URGE? SIM NO SOMETIMES
DO YOU HAVE SEXUAL TRAUMAS? YESNO
IS IT PEDOPHILIA? YES NO
SIM
HAVE YOU EVER COMMITTED BESTIALITY? NO
HAVE YOU EVER FELT LIKE YOU WERE BEING WATCHED OR FELT LIKE THERE WERE PEOPLE NEARBY, EVEN THOUGH THERE WAS NO ONE? SIM
NO
HAVE YOU EVER HAD HALLUCINATIONS? SIM NO HOW WAS IT?
ARE YOU AFRAID OF BEING ALONE?_________WHY?____________________________________________________________________________
SIMNÃONÃOSIMNÃOPOR
ARE YOU AFRAID OF THE DARK? QUÊ?
ARE YOU AFRAID OF THUNDER? YES ARE YOU AFRAID OF STORMS?
ARE YOU AFRAID OF DYING? [ ]YES[ ] NO WHY-------------------------------------------------------------------------------------------------------------------
ARE YOU AFRAID OF BUGS OR INSECTS? NO, WHY?
OTHERS: ________________________________________________________________________________________________________
HAVE YOU BEEN SUFFERING FROM FAINTS, VOMITING, DIZZINESS? ____________WHY?___________________________________________________________

Counseling Form Page 7

 RELEASE FORM NEW JERUSALEM BAPTIST CHURCH
Ministry of Spiritual Warfare Generation of Gadites

Have you ever suffered from emotional imbalance? SIM WHY NOT?

NO,
HAVE YOU RECEIVED PSYCHIATRIC OR PSYCHOLOGICAL TREATMENT? WHY?

ABOUT YOUR DEVELOPMENT

HER CONCEPTION WAS:
A PLANNED PREGNANCY? SIM NO
DID YOUR PARENTS WANT YOU TO BE OF ANOTHER SEX? SIM NO
DID YOUR PARENTS NOT WANT THE PREGNANCY?
SIM NO
Did your parents think about or attempt abortion? SIM NO

YOUR DELIVERY WAS:

NORMAL
CESARIANA
THERE WERE COMPLICATIONS
FORCEPS WERE USED

IN YOUR CHILDHOOD YOU:

I was treated with injustice
WENT THROUGH A LOT OF FEAR
WENT THROUGH MANY PRIVATIONS
OTHERS:____________________________________________________________________________________________________________
DESCRIBE YOUR RELATIONSHIP WITH YOUR PARENTS: _____________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
AND YOUR RELATIONSHIP WITH YOUR SIBLINGS, DESCRIBE: ________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
SIM
HAVE YOU HAD AN ACCIDENT? {"NÃODEIXOU SEQUELAS?":"DID IT NOT LEAVE AFTERMATH?","EM QUE PARTE DO CORPO?":"IN WHICH PART OF THE BODY?","FICOU DEFICIENTE?":"DID IT BECOME DISABLED?"}

DIFFICULTIES YOU HAVE BEEN FACING:

IN MARRIAGE AT WORK AT SCHOOL IN THE CHURCH AT HOME

DESCRIBE THE DEFECTS OF YOUR HUSBAND OR WIFE:

_________________________________________________________________________________________
DESCRIBE THE QUALITIES OF YOUR HUSBAND OR WIFE:
_________________________________________________________________________________________

What is your relationship with your mother-in-law and your family members? GREAT BOM REGULAR BAD

YOUR INFORMATION IS KEPT CONFIDENTIAL !!! WE WANT TO ALERT YOU THAT YOUR TOTAL RELEASE DEPENDS ON YOUR SINCERITY
ABSOLUTE; DO NOT HIDE ANYTHING, AS IF THE MINISTRATION IS NOT COMPLETE, IT IS YOUR FULL RESPONSIBILITY. NOTE: THIS QUESTIONNAIRE CONTAINS A
A VERY LARGE NUMBER OF QUESTIONS, AS VARIED AS POSSIBLE. THE ITEMS DO NOT ALWAYS MEAN TOTAL AND FINAL COMMITMENT, FOR EACH PERSON THE
DEVELOPMENT IS DIFFERENT, AND IT IS A DIFFERENT CASE. WE APPRECIATE YOUR COOPERATION IN RESPONDING.

Therefore submit to God, resist the devil and he will flee from you (James 4:7)
RELATE NAMES OF PEOPLE YOU HAVE BEEN SEXUALLY INVOLVED WITH:

NOMES: _________________________ _____________________________ ____________________________

_________________________ _____________________________ _____________________________
_________________________ _____________________________ _____________________________
_________________________ _____________________________ _____________________________

Counseling Sheet Page 8