NCC Pastoral Care & Prayer Meeting/Referral Form

Full Name

Email Address:

Assistance Requested:

Prayer Ministry Appointment

Pastoral Care Appointment

Counselor Recommendations

NCC Campus You Attend:

Preferred Meeting Time:

Weekdays (Anytime)

Weekdays (During work hours)

Weekdays (Evenings)

Weekends

Other

Most Convenient Meeting Location:

Other

Level of Urgency:

For mental health emergencies, contact PRS CrisisLink (703-527-4077) or go to your nearest emergency room.

Additional Resources

Other resources you may find beneficial

COVID-19 Care Resources

Resources for general mental health, anxiety, depression, disordered eating, domestic violence, finances, grief, parenting, relationships, and suicide prevention.

Celebrate Recovery

12-step program for all hurts, habits, and hang-ups that runs year-round -- You can join at any time!

Care-Oriented NCC Groups

Depending on the semester, this can include groups dealing with marriage preparation, finances, infertility, pregnancy loss, sexual trauma, divorce, grief, critical illness, and more.

Sozo Inner Healing Prayer

Sozo prayer brings freedom and deliverance in many areas including anger, bitterness, unforgiveness, hatred, sexual brokenness, racial tension, and family dynamics.

Regeneration Ministries

Local ministry helping people find wholeness in identity, intimacy, & sexuality.

Rock Recovery

Local ministry helping those struggling with disordered eating.

Any additional information you would like to provide:

By submitting this form, I acknowledge that pastoral care team and prayer team members are not necessarily professional licensed counselors and make no guarantee or promise of any particular result from the care they provide. I release the pastoral care and prayer team members, National Community Church, and its pastors from any action related to pastoral care and ministerial services.

Send me a copy of my form

WHERE DOES THIS FORM GO? When you submit this form, the information will be transmitted to our pastor of prayer if you are requesting a prayer ministry appointment and to your campus pastor if you are requesting a pastoral care appointment or counseling recommendation. Questions? Contact Ryan Zempel, NCC's Pastor of Recovery and Care.