Pastoral Care Request
In addition to the Joys, Sorrows, and Milestones cards which will still be available to you in the Sanctuary once the church reopens, this electronic form is for Emersonians, Visitors, and Friends of Emerson to share these moments with the Lay Pastoral Ministry Team (LPMT), and to request contact by a team member.

NOTE: If you feel another member would benefit from contact with the LPMT, we strongly encourage you to have them complete this form themselves. We understand there are times when the individual may not be able to reach out personally, in that case you may complete this form on their behalf, with their permission.
1. Email address *
2. Your Name *
3. Your phone number *
4. Would you like someone to contact you? *
Choose one.
5. What is the best way to contact you? *
Check all that apply.
Required
6. What is the best time to contact you? *
7. Please select one of the following. I am a _______: *
Check all that apply.
8. Your Joy/Sorrow/Milestone: *
9. Would you like your joy/sorrow/milestone to be held up in the LPMT’s monthly circle of prayer? *
Choose one.
10. If you are completing this form on behalf of someone else with their permission, please provide your email name and email address or phone number:
Submit
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