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Personal Information (1/4)

The information you provide on this form will be made available to Ronald Zabel as your reconciler. There are four (4) sections to this form. Please complete all sections. Your information will not be submited until you click the submit button at the end of section four.

Highest Education Level Achieved:
Physical Health:
Marital Status:
Interview Agreement

Thank you for your interest in reconciliation. Our goal is to help guide Christians involved in conflict to remember their reconciliation with God and to reconcile with one another as children of God (2 Corinthians 5:16-21). This Interview Agreement sets forth our mutual expectations for using our reconciliation services, including an initial consultation.

We believe that the Bible provides thorough guidance and instruction for faith and life (2 Timothy 3:16- 17). Therefore, beginning with what God has done for us through Christ, we base our services on scriptural principles rather than those of secular psychology or psychiatry. God’s Word urges us to live in peace with each other by promoting understanding, personal responsibility, justice, and reconciliation (Romans 12).

All of our services are provided according to the Rules of Procedure found in Guidelines for Christian Conciliation published by the Institute for Christian Conciliation. The Rules are incorporated in this agreement by reference as set forth in their entirety. (You can view the Rules online at

Not Legal Representation – Christian reconciliation may be used to resolve legal disputes (Matthew 5:23- 26; 18:15-20; 1 Corinthians 6:1-8). Even so, our reconcilers do not provide the kind of legal advice and advocacy that can be obtained through a personal attorney. We work with and for all of the people in a dispute helping them to find a mutually satisfactory agreement. Therefore, if you are concerned about your legal rights, you should consult with an independent attorney who would be willing to accompany and advise you, if you deem it necessary, during the reconciliation process.

FeesThere is no fee charged for a 30-minute initial consultation. After initial consultation, our standard reconciliation fees will apply.

Confidentiality is an important aspect of the conciliation process and we will carefully guard the information you entrust to us. However, we may need to divulge information to appropriate authorities if there is a clear indication that someone might otherwise be harmed (see Rules of Procedure 16 and 17). You agree not to discuss our communication with people who do not have a necessary interest in the reconciliation process. By participating in this process, you agree to treat all dealings with us in regard to this dispute as settlement negotiations, which means they will be inadmissible in a court of law or for legal discovery. Furthermore, you agree that you will not try to force any reconciler to divulge any information acquired during reconciliation or to testify in any legal proceeding related to this dispute.

Our Commitments to You – We desire that parties be given the opportunity to tell their story in a safe environment and to lay their burden at the foot of the cross. To that end we will:

  • Listen with caring, compassionate concern, seeking to understand and to be supportive.

  • Provide you with the opportunity to tell us what is needed for healing and restoration.

  • Bring the Gospel to bear as we have opportunity, including confession and forgiveness.

  • Provide biblical coaching to help you live out your vocation as children of God in your disputes.

  • Keep confidences, only reporting to authorities what is appropriate or required by law (see above on confidentiality).

Please complete the following fields to indicate your agreement with these terms:

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Preliminary Statement of 
Issues and Remedies

The following questions are designed to assist Ambassadors of Reconciliation in developing an Issues Statement for your case. The answers will also assist AoR in appointing or nominating reconciler(s) whom are gifted to your conflict or dispute. A copy of this page may be provided to the other party(s). Please frame your responses in a conciliatory manner to promote dialogue with the reconciler(s) and the other party(s).

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