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Church Consultation Form
This form is to be completed by HN/IMP partners and associates when consulting with a church.
*Please enter the FULL name (ie. Highland Oaks Church of Christ, instead of Highland Oaks)
Location of Church
Name and Contact Info for your Primary Contact Person at the Church
What is YOUR name?
Type of Service Provided by HN/IMP (during THIS consultation)
Leadership Team Consult
Thomas-Kilmann Conflict Mode Instrument (TKI)
Grip Birkman Blueprint (GBB)
IMP Full Service
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.
Current Health Status of the Church
Wellness Visit (Vision, Mission, etc)
In Need of Help
Risk of Closing
Upload additional files and information below.
(congregational surveys, additional notes and info from the consultation, etc)
Drop files here or
Max. file size: 128 MB.
This field is for validation purposes and should be left unchanged.
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