GA Wildfire Chaplaincy Care Report Form

Date of Chaplaincy Care

Email

Chaplain First Name

Chaplain Last Name

Family Ministered To

Hours Spent Ministering

Case Notes

Immediate Needs Identified

Locations of Ministry

Family Wellbeing Rating

Upload any pictures or videos you took when ministering to the family today (up to 5 files.) Remember you may not share these photos or videos yourself in any way shape or form.

After you click submit, the form will reset so you can complete another report for the next family. If the form clears, your report was successfully received.

Georgia Wildfire Disaster Relief Chaplain Report Form