Pastoral Care (CONFIDENTIAL)

Genesis Church believes in biblically based pastoral care as part of our ministry to church members and our community. Our team consists of pastors, ministers, and volunteers who are trained and equipped to help others deal with the challenges and difficulties we all often face.

Please note, Genesis Church and our pastoral care team does not provide any form of professional mental health or counseling services and is unable to provide immediate response to medical or psychiatric emergencies.

If you are experiencing a medial or psychiatric emergency, please call 911 to receive immediate help.

Confidentiality: All forms and interactions with our pastoral care team are confidential and private.

Your name *

Email address *

Personal Information

Phone number *

Address

Birthdate *

Gender *

Marital status *

Pastoral Care Questionnaire

The following questions will better help us understand your needs and how we can help!

Are you a member of Genesis Church? *

Are you part of a Small Group? *

Are you currently serving on a Dream Team?

What situation or issue are you seeking pastoral care for? *

NOTE: Your answers on this form are completely confidential

How do you envision our pastoral care team helping you? (OPTIONAL)

Is there anything else you would like our team to know? (OPTIONAL)

How would you like for us to contact you? *

Text ONLY

Email ONLY

Text or Email

I understand that Genesis Church and the pastoral care team does not provide any form of professional mental health or licensed counseling services and is unable to provide immediate response to medical or psychiatric emergencies. *