Shepherd’s Heart Ministries

Ministering Life and Purpose through Prayer, Mentoring and Teaching

Dan & Cindy Smith, Prayer Ministers

11385Private Dr. 5316, Rolla, MO65401

Office 573-368-7258, FAX 573-368-7258, Cindy’s Cell 573-578-7258

DearFriend,

Thank you for inquiring about Shepherd’s Heart Ministries. Our mission is: To see individuals strengthened, and lives made whole through prayer, and application of Biblical principles.

Shepherd’s Heart is a prayer-ministry. Our goal is to see people set free through prayer and the counsel of God’s Word. We have been thoroughly trained in Biblical principles of prayer ministry through: Elijah House;C.A.R.E.;Theophostic®; Restoration in Christ Ministries; I Found Freedom; Ask Jesus; and Sozo. Both basic and advanced training in these disciplines have been taken. In addition, Cindy took an Internship with Dr. Ed Smith in Theophostic® Ministry* on ministering to those with, Eating Disorders, Anxiety, P.T.S.D., and DID. Cindy received training in Levels I, II, III and IV at Christian Healing Ministries in Jacksonville, FLwith Dr. Francis and Judith McNutt. Our experience has shown that emotional pain, conflicts, disorders, sexual problems, etc., all have a source and origin – a beginning. When the Lord brings healing at its source, it is lasting!

All of us are wounded to some degree by past experiences in our lives and can benefit from prayer-ministry. If you struggle from a negative emotion such as shame, fear, anxiety, abandonment, depression, worthlessness, hopelessness, powerlessness, confusion, etc., you can find freedom. We are not licensed counselors, psychologists, or psychiatrists,nor do we offer psychological or medical treatment.Those under medical or psychological care should remain in such care until released.

This prayer-ministry approach helps people to:

-Receive healing for emotional hurts and wounds;

-Recognize root causes of problems (lies, judgments, inner vows, unforgiveness, etc.);

-Accept responsibility for their part in the healing process;

-Allow God to effectively deal with their hearts at the root level.

This ministry is supported through giving. While we do not charge a set fee, we do encourage clients to make a regular contribution to this ministry each visit. A suggested donation per single session (an hour) is $30. The suggested fee for overnight stay in the apartment is $10 per night. All are welcome regardless of financial status. Please make checks payable to: Shepherd’s Heart Ministries.

Enclosed please find theMinistry Release and Disclaimer, as well as the Pre-Ministry History Form. Please complete these as thoroughly as you are able. This will assist us in making preparation for your appointment. After completing the forms, please bring them with you. Be assured that these forms will not be reviewed by anyone other than Dan and/or Cindy Smith.

If you have any questions, please call 573-368-7258.

Dan & Cindy Smith

* Shepherd’s Heart Ministries uses the name Theophostic®with written permission from, (but is not sponsored by or affiliated with), Alathia Ministries, Inc. Theophostic® Ministries is a trademark of Dr. Ed Smith and Alathia Min. of Campbellsville, KY. For more information, see: or call 1- 888-467-3757.

Shepherd’s Heart Ministries

Ministering Life and purpose through Prayer, Mentoring and Teaching

Dan & Cindy Smith, Facilitators

11395 Private Drive 5316, Rolla, MO65401

Office 573-368-7258 Fax 573-368-7258

MINISTRY RELEASE, DISCLAIMER and CONFIDENTUALITY FORM

You have a right to know: Disclosure, Information and Agreement

The purpose of Shepherd’s Heart Ministries is for spiritual growth and healing. It is not a psychological counseling service, nor is it intended to be. I understand that the team members are not licensed counselors, or psychologists, but trained in using the Word of God and prayer through the power of the Holy Spirit. The ministry tools include Elijah House Principles, Theophostic® Ministry, Restoration in Christ Ministries, C.A.R.E. Inc., Immanuel, Sozo,andAsk Jesus. The results of this approach depend on the willingness of the individual to make wise choices consistent with the teaching of Jesus Christ. I understand that I have the right to ask any questions at any time about the process of prayer ministry, and to stop the prayer ministry at any time I choose. I also understand that I will not be forced to participate in any prayer or deliverance ministry against my will at any time.

I further understand that according to I Corinthians 6:1-8, we as Christians should refrain from suing each other and that all prayer-ministry is being undertaken with the understanding that we will abide by that scriptural premise. I do further agree to hold harmless Shepherd’s Heart Ministries, its agents, employees, board members and owners from any and all liability.

All personal information gathered in the course of a ministry session is confidential, and the files are so maintained. I do hereby give permission for the prayer-minister to consult with other members of the team as is needed (names are not used). Case records are strictly confidential. No outsider, not even your closest relative or family member or family doctor is permitted to see your case record without your written permission.

Intern training is a part of our commitment to the task of restoration and transformation to individuals and families. As you participate in the sessions, you may have the opportunity to work with your prayer-minister and a qualified intern who has been assigned. Please be assured that we always adhere to a strict policy of confidentiality, which includes the interns working with clients.

To comply with legal regulations, any planned or recently attempted suicide, child abuse, or criminal behavior will be reported to the proper authorities.

This ministry is supported through giving. While we do not charge a set fee, we do encourage clients to make a contribution to this ministry each visit. A suggested donation per single session (an hour) is $30. All are welcome regardless of financial status. Please make checks payable to: Shepherd’s Heart Ministries.

I, (please print recipient’s name)______understand the foregoing information concerning this ministry. I have sought this ministry of my own free will and all personal information I reveal is given voluntarily in order to facilitate the team members working with me. I have read, and understand, all the terms of this agreement.

______(Signature of Recipient) ______(Date)

______(Address) ______(Phone)

______(City) ______(State) ______(Zip)

______(E-mail)

______(Parent Signature is client is under 18)

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