Illness Services Request

Name*

Last name*

Phone number*

Your email*

Please state category announcement. (Sick, Surgery, Tests, Other). If other, please specify*

Name of sick family member*

Relationship to GLFC member*

Please indicate status of patients. (Home, hospital/facility, other). If other, please specify.*

Name and address of the Hospital/Facility.*

May we list information in the announcement/bulletin?*

Is it okay to visit*

Yes

No

Submitted By:*

Find Us

201 S. Dallas Ave. Lancaster, Tx 75146 (inside FUMC)

Sunday Service at 11:00 AM

You are always welcome