Prayer Request Form
Name of person filling out this form.
Please list a phone number or email address where you can be reached, should we need to contact you.
Name of the person in need of prayer.
Please briefly describe your relationship with this person, ex. "my mother," or "friend of the family."
Is the person in need of prayer a member of St. Mary's?
Should we pray for this person by name during our worship service?
Yes, mention by name
No, mention by relationship
If the person is in the hospital, please leave the name of the hospital and room number. Let us know if they would like a visit from a priest.
Do Not Fill This Out