Bikkur Cholim - Request a Visitor - Form

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Bikkur Cholim - Request a Visitor

"Bikkur Cholim" translates to "visiting the sick." Beth Jacob's Chesed Committee has volunteers ready to visit community members and their families when they are ill or confined and in need of visitors. Such visiting is integral to the well-being of our community, enriching the lives of those being visited and of the visitors.

If you would like a visitor, please fill out the form below:

Your Name

I am requesting this visit for myself

YesNo

IF YES,
Continue Below

If NO: ►

Name/Relationship of person who could use a visit

Address for the Visit

Name and contact information for reaching out to schedule the visit

Good Times/Days for Visits

What are your interests?

What would you like us to know about you to make the visit a positive experience?

Thank you! We will be in touch shortly.