Prodigal Questionnaire Date * MM DD YYYY Name * First Name Last Name Name and age of your prodigal Do you have any adopted children? YES NO Is yours a blended family (children from each side)? YES NO Was your prodigal raised in the church? YES NO Did your prodigal make a profession of faith? YES NO What best describes your prodigal’s behavior? (check all that apply) Addicted to drugs Addicted to alcohol Addicted to marijuana Addicted to porn Addicted to video games Rebellion Lying Other Briefly describe "other": Who in the immediate family are the enablers (check all that apply)? Parent Brother Sister Other Who is the "other"? Are there enablers outside the immediate family? YES NO If YES, who are they (name and relation)? List any other family members or individuals who are impacting your current situation (Please identify if they are a positive or negative influence and how they are impacting your situation.) Identify what the chaos in your life looks like (i.e. - financial, relational, fear of harm, other) What are the greatest obstacles and fears in controlling the chaos in your family? Obstacles: Fears: What has caused previous plans to fail? Can you identify the event(s) that were your "tipping point" for seeking out The Prodigal Ministry? During the Prodigal curriculum, we will spend some time considering where you look to find purpose and meaning in life. As a starting point for that conversation, please jot down a few ideas now for what you are currently thinking as to your life’s purpose. Please don’t worry about making your statement perfect, as we will revise it over time. Just describe what comes to mind when asked about your purpose. Clicking SEND will submit this form to help@myprodigalroad.com Thank you!
