Love in Action

First Name*

Last Name*

I reached out to (name)*

Date*

How did you Reach Out? (ie phone, card, note, in-person etc)*

Comments or Concerns

I refer this person(s) to the Pastor for Follow-up*

Would you like a card sent to this person(s)?

Would you to like to speak to the Pastor about this person(s), if "Yes" the Pastor will contact you first

Would the person like prayer from the prayer ministry? (Johanna) ... - Only "yes" responses will be given to the prayer ministry)