Care Request Form

Confidentiality Disclaimer:
All information submitted through the Care Request Form and shared in connection with Care at Port City Community Church is treated as confidential. Submissions are reviewed only by our Care Team and are used solely to help direct you to the most appropriate support and resources.

We recognize the courage it takes to ask for help, and we consider it an honor and privilege to hear your story and walk alongside you.

There is strength in community, and we want to surround you with care and encouragement as you navigate this season. Please complete this form with as much information as you feel comfortable sharing—it will help us guide you toward the best next steps, whether that’s pairing you with a 1-on-1 Care Advocate, a Care Group, or another helpful resource.

Our Care Advocates are trained volunteers and staff who offer a safe space to share, reflect, and find encouragement through prayer and Scripture. Their primary focus is to walk with you in your relationship with Jesus, whom we believe is our greatest source of healing, comfort, and hope.

We also offer a variety of Care Groups and maintain strong partnerships with local clinical resources. We deeply value the role of licensed counselors and social workers, and we believe they offer powerful tools and insights to support those in difficult seasons.

After you submit this form, one of our Care Coordinators will follow up with you to talk through the options available. Thank you for trusting us with your story.