Sick and Shut In / Prayer List Report
Please let us know about those who are sick and shut in or need prayer
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Sick and Shut In
Name of Member/Person who is Sick *
Related to (Member name) if any
Name of Person Reporting the situation.
Date of Condition if Known
MM
/
DD
/
YYYY
Please Describe Condition if Known *
Did you personally reach out to the individual? *
Were you successful in making contact? *
Additional Comments
Does the person need to be served Communion? *
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