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Pastoral Assistance Report Form

Fill out this report for your P.A.T. visit. Pastor Brian Thomas will receive your report via email. Thank you for serving our Lord through the ministry of care and compassion.

Your name *

Last name

Email address *

Care Receiver's Name

Date of Visit

Short Description of Your Visit

Type of Visit

Home or Care Center

Hospital or Rehab

While at Church

Phone Call

Condition of Person

Improving

Stable

Declining

Suggested Follow-up

Pastoral Visit

Contact with Family Needed

Angel Benevolence Assistance Needed

Communion

GriefShare Recommended

4:10 Help Minor Repairs

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Palm West Community Church
finance@palmwestchurch.org
6235462980

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