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Welcome Home, Antioch Christian Church Members!
Care Support & Pastoral Connection
Welcome Home, Antioch Christian Church Members!
Care Support & Pastoral Connection
Care Support & Pastoral Connection Request Form
Antioch Christian Church
This form is designed to help us serve you with care, prayer, and pastoral support. All requests are handled with confidentiality, compassion, and discretion.
"
*
" indicates required fields
Step
1
of
4
25%
Name
*
First
Last
Email
*
Enter Email
Confirm Email
Contact Phone
*
Preferred method of contact
*
Call
Text Message
Email
In-Person Meeting
Virtual Meeting
Membership Status
Check which applies:
*
Antioch Member
E-Member
Regular Attendee
New to Antioch
Type of care requested:
*
Check all that apply
Prayer Request
Pastoral Counseling
Grief Support / Bereavement
Hospital / Health Support
Marriage / Family Support
Emotional / Spiritual Support
Crisis Support
Homegoing / Funeral Support
Ministry of Kindness (Financial / Practical Assistance)
Other
If other, please list or describe below:
Request Details
Please share as much as you are comfortable. This helps us respond with care and wisdom.
*
Urgency Level
*
Immediate (within 24 hours)
High Priority (1–3 days)
Standard (as soon as available)
Pastoral Connection Preference
Who would you like to connect with?
*
Senior Pastor
Executive Pastor
Elder / Minister
Intercessory Prayer Team
Shepherd’s Ministry Team
No preference
Consent & Confidentiality
*
I understand that this information will be shared only with appropriate pastoral leadership and care teams for the purpose of providing spiritual care and support.
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