JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Cholim Submission Form
Use the form below to submit names of individuals to include on Kesher Israel's cholim list.This list will be cleared once per quarter (with advance notification); you will need to resubmit any names as needed.
If you have any trouble with the form below, please email the name(s) for inclusion to
info@kesher.org
or call 202-333-2337.
Sign in to Google
to save your progress.
Learn more
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
