Hub Care Team Follow-Up Report
Name
*
First Name
Last Name
E-mail
*
My Campus
*
Culpeper
Fredericksburg
King George
Richmond
Spotsylvania
Stafford
Select the specific area of the need:
*
General situational or emotional needs Marriage (couples)
Financial Freedom
Parenting
Youth Issues (abuse, self harm, etc)
Physical healing
Grief after loss of a loved one
Spiritual warfare/freedom from demonic forces Addictions
Baptism in the Holy Spirit
Enter the first and last name(s) of the individual/couple you are providing care for:
*
How difficult was it to make this connection?
*
Did not connect
Extremely difficult to connect
Hard to get connected
Normal connection
Easy to connect
Date of your connection:
*
-
Month
-
Day
Year
Date Picker Icon
Where did you connect with the individual/couple?
*
How many times have you connected with the individual/couple?
*
Do you plan on connecting with them again?
*
Yes
No
The person prefers not to meet again
I do not believe meeting with them will be productive
Did you encourage them to get plugged into a small group?
*
Yes
No
List any groups you suggested to them below:
Has the individual or couple committed to join a small group?
*
Yes
No
Enter a summary of care below:
*
How responsive do you feel the individual or couple was during your connection?
*
Very responsive
Somewhat responsive
Resistant
Contentious
Is there anything more your leaders could have done to help you provide care?
Submit
Should be Empty: