Deacon Minister Visitation Form

VISITATION & MINISTRY ASSIGNMENT REPORT

The deacons' and ministers' tool for visits and support to CTK members and families.
Date Submitted:
Submitted By:
Please provide your first and last name
Minister
Mark with an X
Deacon
Mark with an X
Date of Visit/Assignment:
Ministry Type & Purpose of Visit (Check All That Apply):
Other (Please specify):
Names of Individual(s) Visited or Served:
Location of Visit (Home, Hospital, etc.):
Contact Number (if applicable):
Outcome / Observations (Brief visit summary/or updates (e.g. physical/emotional condition, needs etc.)):
Next Steps / Follow-Up Needed:
Type a question
Frequency recommended for Minister/Deacon
Mark X if applicable
Additional support requested, e.g., meals, transportation (List below):
Follow-up visit by the following recommended (Check All That Apply. List frequency if known):
Additional Notes or Comments:
Would individual like to remain on the prayer list at this time?
Should be Empty:

VISITATION & MINISTRY ASSIGNMENT REPORT