Request Pastoral Care

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Hi Bethany,

Bethany's pastoral team is here for you. You are not alone. If you or someone you know is in need of pastoral support of any kind, take a moment to complete this.

We have gathered pastors, deacons, and trusted lay leaders who are ready to come alongside you with prayer, encouragement, visitation, and care. Once this form is submitted, someone from our care team will review it and follow up as appropriately and as soon as possible.

- On behalf of Bethany's Pastoral Team

Who is this request for? *

For myself

For someone else

Name of the person in need?

If for yourself, write your name.

What is the best way to reach you? *

Phone Call

Text message

Phone Number and/or Email Address *

What kind of support are you requesting? (Select all that apply) *

Prayer

A phone call

A hospital visit

Communion (home/hospital)

Pastoral Counseling

Grief Care/Funeral Care

Other:

Required

How can we support you?
Briefly describe the care or support you need *

How urgent is the request?

Urgent (as soon as possible)

Within the next few days

Within 2 weeks

Clear selection

Submit

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