In need of care

Please fill out this form if you or someone you care about is in need of a ride, visit, prayers, or other care from the GCC Congregational Life Team and Ministers.

Please fill out the following fields to provide your contact information. An email address and/or phone number is required if you would like us to follow up with you, and an address is required if you would like an in-person care or delivery.

Name

*

Email

This address will receive a confirmation email

Phone

Address

Please use the following fields to tell us what kind of care you are requesting:

What type of care are you seeking? Select all that apply:

*

Please select all that apply.

Prayers Phone call Letter/postcard In-person visit Meal Car ride Altar flowers Other (describe below)

Describe your need in as much detail as you are comfortable sharing (prayer request, ride date/time/location, etc.)

*

How would you like to be contacted?

*

Please select all that apply.

Phone Email Please do not contact

Description

Please fill out this form if you or someone you care about is in need of a ride, visit, prayers, or other care from the GCC Congregational Life Team and Ministers.

Please Fix the Following

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