Deacon's Visitation and Prayer Request Form

Fill out this form to inform the Deacons of pastoral visits or calls you have made or to request prayer for someone.

MEMBER INFORMATION

Fill in information about the congregation member.
Name Name First Last
Date of Visit or Contact Date of Visit or Contact / MM / DD YYYY
Status or Details of Situation:
Anything this person(s) might need:
Would this person like a pastor to contact them?

Would this person like a pastor to contact them? Yes No
Please Select One

Please Select One This information is confidential, do not share with Deacons. This information can be shared with the rest of the Deacons.
DEACON INFORMATION
Deacon Name Deacon Name First Last
Deacon Email