HomeBound Ministry Request

A Calvary Chapel FourteenSix Ministry for the sick and shut in. Tailored home visits for those who are unable to attend church services regularly. Our ministry of volunteers will give those in need the opportunity to "Discover the Full, Abundant Life in Jesus" from the comfort of their home.

Your name *

Email address *

EMERGENCY CONTACT INFO

Emergency Contact Name *

Emergency Contact Relationship: *

Emergency Contact Phone Number: *

HOME AND HOUSEHOLD INFORMATION

Are there any health conditions volunteers should be aware of (non-medical)? *

Will others in the home be participating in the visits? *

Are there any known safety concerns in the home (trip hazards, pets, clutter, etc.)? *

Are there any stairs in the home? *

SPIRITUAL AND SOCIAL NEEDS

What type of visits are you or your loved one needing/desiring? *

How often would you like a visit? *

PERMISSION AND CONSENT *

I understand and agree that HomeBound Ministry volunteers from Calvary Chapel FourteenSix are not medical professionals and cannot provide medical treatment, but may offer fellowship, prayer, spiritual encouragement, and companionship during home visits. I consent to volunteers entering the home for ministry purposes, interacting with the homebound individual, and contacting me or the listed emergency contact if any concerns arise. I acknowledge that visits are voluntary, provided as a ministry service, and may be adjusted or discontinued if safety, health, or scheduling concerns require it.

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