All information provided in this intake form is strictly confidential. Your responses will only be viewed by authorized members of Hearts Restored Ministry who are directly involved in supporting your care and healing process. We take your privacy seriously and will protect the information you share with us to the fullest extent possible.

By completing this form, you acknowledge and agree that the information you provide will be used solely for ministry support within Hearts Restored Ministry.

Heart’s Restored Ministry is a Christ-centered refuge focused on healing, restoration, and hope for survivors of abuse. Our purpose is to walk alongside those who have experienced trauma, guiding them toward wholeness through the power of God’s Word, prayer, and loving community.

We are committed to breaking cycles of silence, shame, and broken identity by offering support, biblical teaching, and Spirit-led care that addresses the wounds of the past, the importance of forgiveness, and helps to empower individuals to embrace a future marked by freedom, dignity, and purpose.

Heart’s Restored Ministry seeks to reflect the heart of Go—binding up the brokenhearted, setting captives free, and helping every survivor rediscover their worth, walk in victory, and live restored.