UUCT Care Team Request
"The focus of the Care Team at UUCT is to facilitate communication with members who are not able to attend church events or those who may need caring outreach during difficult life experiences. Volunteers are available to provide temporary assistance in cases of need. Actions such as phone calls, home and hospital visits, or sending cards are performed in accordance with UU Principles and may include help with transportation and meals. When long-term assistance is needed, the Care Team members seek referral for wider community services."

This form may be completed by members and friends of UUCT to let UUCT's Care Team know about their health and related concerns. This form will be sent to Rev. Bethany and the Care Team chair, Aston Bloom, who will follow-up with the UUCT Member/Friend. If you are completing this form for someone else, please first confirm that you have their permission to communicate about their health need.

If there is an emergency (someone is in the hospital, actively dying, immediate need for assistance, etc.) please call or text Rev. Bethany directly.

First, we ask that you fill out your information so that we know who is submitting this form, in case it is different from the Member/Friend with the Care Team Request.
Your Name *
Your answer
Your Email *
Your answer
Your Phone Number *
Your answer
First and Last Name of Member/Friend (if different from above)
Your answer
Phone Number (if different from above)
Your answer
Email Address (if different from above)
Your answer
Mailing Address
Your answer
Please briefly describe the reason for submitting this Care Team request. *
Your answer
Please indicate which type of follow-up the UUCT Member/Friend would appreciate
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