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St. John in the Wilderness Homebound Ministry Visitor Reporting
Church Office: 828-693-9783
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* Indicates required question
Please select what type of visit you made.
Eucharistic
Pastoral Care
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Person Visited
*
Your answer
Date of Visit
*
MM
/
DD
/
YYYY
Time of Visit
*
Time
:
AM
PM
Total Number Present
(include yourself)
*
Your answer
Number Receiving Eucharist
(if applicable - include yourself)
Your answer
Comments/Needs Noticed on Visit
*This box will expand the more you type in it. There is no character limit.
Your answer
If the visitee's address or phone number has changed, please make a note of it below.
Your answer
Eucharistic/Pastoral Visitor Name
*
Your answer
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