Buckley Road Baptist Church - Visitation Tracking Form

Please fill out this church ministry survey form and click submit.

Visitation Details

Date of Visit

*

Time of Visit

Visitation Team Leader

*

Team Leader Phone

Team Member(s)

Type of Visit

*

Please select all that apply.

First-Time Visitor Follow Up New Member Check-In Shut-In/Care Visit Re-Engagement/Absent Member General Outreach / Door-to-Door

Person Visited

Full Name(s) Visited

*

Phone

Email

Address

Visitation Map Section Number (i.e. A5, H3)

Was contact made?

*

Please select one option.

Yes (Spoke To Contact) Yes (Email) Yes (Spoke to Family Member) No (No Answer) No (Moved/Incorrect Address)

Outcome & Notes

Spiritual Outcomes

Please select all that apply.

Prayer Request Recieved Decision for Christ Made (New Convert) Expressed Interest in Membership Requested a Bible or Literature Other

Practical Needs Observed

Please select all that apply.

Food / Financial Need Transportation Need Home Repair / Yard Work Health / Medical Concern

Detailed Visit Notes

*

Follow-Up Needed By

Follow-Up Action

Follow-Up Due Date

Description

Please fill out this church ministry survey form and click submit.

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