Hello! Thank you for taking the time to fill out this questionnaire! If you are filling this form out for an individual with a disability, please understand that the answers to the questions are to be about that person.

Our desire is to get to know you better, learn how we can better serve you, and give you a way to communicate any needs you may have to the Imago Dei volunteers. Please understand that your information may be shared, but only to those who are working directly with the individual. We will only share the information that is absolutely necessary to care for the person. 

**Will insert a form below & will need new logo

Living Water community church

Weekend Services: Saturday 6PM; Sunday 9AM & 11AM

717.564.5003

information@livingwatercc.com​

206 Oakleigh Avenue

Harrisburg, PA 17111

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©2018 Living Water Community Church