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Testimony Form

Name *
Name
Phone *
Phone
The country code for the US is 01.
In less than 300 words, write out the main details of when you got the problem, and it's treatment.
In less than 300 words, write out what God did and how he did it.
Medical Records *
If selected, we will need to collect your medical records. Are you willing to sign a form that will allow us to do so?
Film *
If you are selected, are you willing to be filmed?
Doctors *
If selected, we will need to talk with your doctors. Are you willing to sign a form that will allow us to do so?