Live Oak UU Church Life Crisis Form
The Pastoral Care Team is in the process of gathering emergency contact information of our members. This information will be kept confidential and used by Rev. Joanna or the Pastoral Care Team.
Your Name
Your answer
Date of Birth
Your answer
Name of Primary Contact
Your answer
Relationship
Your answer
Phone Number
Your answer
Name of Secondary Contact
Your answer
Relationship
Your answer
Phone Number
Your answer
Who is/are your Medical Power of Attorneys?
Your answer
What is/are your Medical POA’s phone numbers?
Your answer
Where is the document kept?
Your answer
Thank You, The Pastoral Care Team
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