Friendship Ministry 2021 Question Title * 1. Name of Friendship Minister: Question Title * 2. Name of person you visited: Question Title * 3. Date of Visit Question Title * 4. Time of Visit Question Title * 5. Where did the visit occur? Person's Home Nursing Facility Assisted Living Hospital or Rehab Facility Other: Question Title * 6. If the visit was in a nursing home, assisted living, hospital or rehab facility, which one? Question Title * 7. If you were unable to visit, did you make another type of contact? No Yes If yes, what type of contact? Question Title * 8. Are you aware of other visitors that this person has had? No Yes If yes, who? Question Title * 9. Has the person you visited received Communion recently? Yes No If no, would they like Communion brought to them? Question Title * 10. Are you comfortable serving Communion? Yes No If no, would you like someone else to bring Communion? Question Title * 11. Is there any change in health or residential status? Question Title * 12. Are there any concerns you feel that Redeemer Staff or Pastor Rod or Pastor Debbie should be aware of for prayer or other appropriate action? Question Title * 13. Is there anything else we can do to assist you as a Friendship Minister? Thank you for completing this form and for serving on the Friendship Ministry Team! Please contact Bev Olsen or Wendy Elliott with any additional questions or concerns. Done