Care Needs

Care Needs
This form is used to inform the Care Team of the needs of people who are a part of McCook Christian Church who are going through a challenging season and could use some help.

A Care Team member will reach out to the person in need, to determine how best we can help. There are MANY resources within Relevant to guide people through difficult circumstances.

The information on the form will remain confidential within the Care Team and the pastoral staff.
PERSON WITH CARE NEEDS
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
OTHER INFORMATION
Person Filling Out Form*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
SPECIFIC NEED
What does the person you are filling out the form for need help with?*

Depression/AnxietyElderlyFinancial Needs (will be passed on to benevelence)EncouragementIllnessLoss of JobLoss of a Loved OneNew BabySurgeryOther (please put what you know in the following question)
Information about the need: the more information you can give us the better. If you don't have any more info, just write that.
Should be Empty:

PERSON WITH CARE NEEDS