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Member Care Form
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The mission of the Member Care Committee is to support our members by welcoming new members, celebrating joyful occasions and providing support in times of transition and need, consistent with TBE's mission and Jewish value of
Gemilut Hasadim
, acts of loving kindness. Typical types of support offered by the member care team include meals, transportation assistance, and check-in calls. Please let us know how we can help.
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Is this support request for you or someone else?
Please Select One
I need support
I am requesting support on behalf of someone else
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What is your name?
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What is your email?
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What is your phone number?
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What is their name?
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What is your relationship to this person?
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Does the person you are submitting on behalf of know that you are reaching out to TBE?
Please Select One
No
Yes
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Please give us a sense of what kind of support this person needs and why. Please also give us an indication of how sensitive or confidential this information is.
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Please give us a sense of what kind of support this person needs and why. This information will be shared with the Member Care Team.
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Please provide some context for the assistance that you are requesting. This information will be shared with the Member Care Team.
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Should the care recipient be contacted?
Please Select One
No
Yes
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Would the care recipient be comfortable being contacted by someone on the Member Care Team?
Please Select One
No
Yes
What is the care recipient's email?
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What is the care recipient's phone number?
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How would the care recipient like to be contacted?
Please Select One
Email, phone call, or text message
Email only
Phone call only
Text message only
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What is your email?
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What is your phone number?
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How would you like to be contacted?
Please Select One
Email, phone call, or text message
Email only
Phone call only
Text message only
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What is the care recipient's address?
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Does the care recipient have any allergies or dietary restrictions that we should know about?
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What is your address?
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Do you have any allergies or dietary restrictions that we should know about?
Would you like the Rabbi to reach out to the care recipient?
Yes
No
Would you like to speak with the Rabbi?
Yes
No
Sat, April 19 2025 21 Nisan 5785
