When did your pains and hurts took place?
In the womb
Childhood
Adolescence
Adulthood

Who offended you?
Father
Mother
Brother
Sister
Relative
Friend
Schoolteacher
Pastor
Others. Please specify.
General description i.e doctor:

Offense:
Sexual Abuse
Physical Abuse
Verbal abuse
Insult
Slander
Others. Please specify:
:

Type your prayer of forgiveness here.
Please be explicit without typing the name/s of the person/s involved:

Have you asked for forgiveness from all the people you have offended since childhood to present?
Yes. All of them
Yes but not all. (Please explain)
No. ( Please explain )
Explanation:

Type your prayer of repentance here.
Please be explicit without typing the name/s of the person/s involved: