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Church Consultation Form
This form is to be completed by HN/IMP partners and associates when consulting with a church.
Church Name
*
*Please enter the FULL name (ie. Highland Oaks Church of Christ, instead of Highland Oaks)
Location of Church
*
City
State
Name and Contact Info for your Primary Contact Person at the Church
First Name
Last Name
Email
Phone
What is YOUR name?
*
Jimmy Adcox
Greg Anderson
Jon Anderson
Lynn Anderson
Randy Daugherty
David Fleer
Mark Frost
Chris Goldman
Carlus Gupton
Rhesa Higgins
Evertt Huffard
Jay Jarboe
Grady King
Jim Martin
Rob McRay
Jon Mullican
Doug Peters
Rubel Shelly
John Siburt
Bret Testerman
Jason Thompson
Phil Ware
Julie Woodroof
Tim Woodroof
John York
Type of Service Provided by HN/IMP (during THIS consultation)
*
Leadership Team Consult
Thomas-Kilmann Conflict Mode Instrument (TKI)
Grip Birkman Blueprint (GBB)
IMP Seminar
IMP Full Service
IMP Consult
Vision/Mission
Leadership Coaching
Shepherd Training
Governance
Stuck
Marriage Care
Retreat
Training/Workshop
Other
Please specify.
Dates Served
Please specify the date(s) you provided this consultation service. If you provided IMP services to this congregation, specify your start date and end date.
Consultation Notes
Current Health Status of the Church
Healthy
Wellness Visit (Vision, Mission, etc)
In Need of Help
IMP Visit
Risk of Closing
Upload additional files and information below.
(congregational surveys, additional notes and info from the consultation, etc)
Drop files here or
Select files
Max. file size: 128 MB.
Comments
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