Pastoral Care Need Submission Form
Purpose: Use this form to report illness, absence, hospitalization, family concerns, or other pastoral care needs so our pastoral team can offer support.
Name
*
First Name
Last Name
Your Relationship to the Person in Need
*
Self
Family Member
Friend
Church member
Volunteer/Staff
Other
Name of Person in Need
*
First Name
Last Name
Type of Pastoral Care Need
*
Illness / Medical concern
Hospitalization
Absence from church
Grief / Loss
Family or relational concern
Spiritual support
In the Military
In College
Other
Brief Description of the Situation
*
Urgency Level
*
Urgent (within 24–48 hours)
Soon (within the week)
Not urgent
Preferred Type of Follow-Up (if any)
*
Phone call
Visit
Prayer only
Email
No follow-up needed at this time
Best Contact Information (phone number/email)
Is This Information Confidential?
Yes, pastoral staff only
Can be shared with prayer team
Not confidential
Submit
Should be Empty: