Notice of Hospital Stay/ Surgery

First name of Patient

Last name of Patient

Your name (if different from patient)

Email of contact person

Phone of contact person

Date of surgery or hospitalizaton

Name of Hospital

Street Address (WHERE RECVOERY WILL TAKE PLACE)

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Room number (if known)

Are there any other details you would like to share?

Thank you for responding. Someone from our staff will contact you.

WORSHIP WITH US

WORSHIP SERVICE

Sundays @ 10:00 AM

EARLY MORNING PRAYER

Tuesdays @ 5:00 AM

MID-WEEK WORSHIP

Wednesday @ 6:30 PM

LATE NIGHT PRAYER

Fridays @ 9:00 PM

CONTACTINFORMATION:

A: 701 Thomas Road

Lynchburg, VA 24502

T: 434-849-8716

E: info@therampchurch.com

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