To assist us at the District would you please fill in the following form it will also assist us in knowing which health evaluation tool you have been using at your local church.

*	Church Name:
*	Date assessment was conducted:
*	Evaluation Tool used:	Natural Church Development (NCD) Transforming Church Index (TCI - Kevin Ford) Church Health Assessment Tool (CHAT - Stephen Macchia) The Church Health Assessment Tool (churchcentral.com) Inventory of Spiritual/Emotional Health (Peter Scazzero) The Complete Ministry Audit (Bill Easum) Facing Reality: Congregational Mission Assessemtn (Tom Bandy) Other:
*	Areas of Greatest Health:	Worship/Prayer Discipleship/Spiritual Formation Fellowship/Relationship Building Leadership/Ministry Training Evangelism Global Missions Other:
*	Areas of Least Health:	Worship/Prayer Discipleship/Spiritual Formation Fellowship/Relationship Building Leadership/Ministry Training Evangelism Global Missions Other:
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