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Friendship Ministry 2021
1.
Name of Friendship Minister:
2.
Name of person you visited:
3.
Date of Visit
4.
Time of Visit
5.
Where did the visit occur?
Person's Home
Nursing Facility
Assisted Living
Hospital or Rehab Facility
Other:
6.
If the visit was in a nursing home, assisted living, hospital or rehab facility, which one?
7.
If you were unable to visit, did you make another type of contact?
No
Yes
If yes, what type of contact?
8.
Are you aware of other visitors that this person has had?
No
Yes
If yes, who?
9.
Has the person you visited received Communion recently?
Yes
No
If no, would they like Communion brought to them?
10.
Are you comfortable serving Communion?
Yes
No
If no, would you like someone else to bring Communion?
11.
Is there any change in health or residential status?
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?
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.