Pastoral Care Request
Complete the following form to notify the pastoral staff of a pastoral care need.
Name of person in need of care
Facility (if applicable)
Select one or enter facility name below
Johns Hopkins - Bayview
University of Maryland Medical Center
(Hospital, Nursing Home, Hospice, etc.)
Point of Contact
Name and contact info for point of contact
Your Contact Info
Phone, email, etc.
Is this information confidential?
Yes - It is confidential
No - It is not confidential
Provide any additional information you feel would be helpful in addressing this pastoral care need.
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