Chabad of Rockland - Mi Shebeirach List
Reminder to remove from list once prayer is no longer necessary
Email address *
Please join us in prayer for those in need of recovery or for those in need of G-d's salvation.
Adding or Removing a name *
Your Name *
Name of person filling out this form
Phone Number *
Relation *
How are you related to the person who needs the blessing?
Tell us about the one needing a prayer
First & Last English Name *
Name of person in need of a prayer
Hebrew Name *
Hebrew Name (if known) of person in need of a prayer
Woman or Man? *
Bat = Daughter of / Ben = Son of
Mother's Hebrew Name *
Hebrew name (if known) of the Mother of the person who is in need of a prayer
What are we praying for? (not required)
Recovery from illness, Surgery, Medical Procedure, etc.
We wish a quick and complete recovery for all those in need! May you come by soon to tell us good news!
A copy of your responses will be emailed to the address you provided.
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