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Pastoral Care Contact Log
Please fill in the fields below to report your visit or contact.
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* Indicates required question
Name of person visited or contacted
*
Your answer
Phone number
Your answer
Address
Your answer
Person who made the visit/contact
*
Your answer
Date
*
MM
/
DD
/
YYYY
Type of contact
*
Visit
Phone call
Email
Social media
Text
Saw in worship
Sent a card/note
Other:
Required
Brief description of visit/contact
*
Your answer
Gave communion?
Yes
No
Clear selection
Add to prayer list?
Yes
No
Already on it
Remove from prayer list
Clear selection
Do they want a visit from Pastor?
Yes
No
Other:
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Submit
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