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Care Assessment
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First Name
First Name is required.
Last Name
Last Name is required.
Email
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Mobile Phone
Mobile Phone is required.
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Which campus do you attend?
Southwest
Bee Cave
Dripping Springs
Highland Lakes
I do not attend
Which campus do you attend? is required.
Describe why you reached out to our Care Team and include context that would be helpful for us to know about your situation.
Describe why you reached out to our Care Team and include context that would be helpful for us to know about your situation. is required.
Have you met with another Pastor or counselor to discuss your situation?
No
Yes
Have you met with another Pastor or counselor to discuss your situation? is required.
If you are requesting to meet with Phillip, Michael, Sunni, or Cheryl specifically, indicate why below
None
I have met with him/her previously
I was referred to him/her by someone
I am not requesting to meet with a specific person
Other
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