Epiphany Prayer Request Form
Thank you for making a request for prayers from our Prayer Chain Ministry. Prayer Ministers commit to praying for the people and intentions shared, treasuring the sensitive and sometimes confidential nature of the requests, and respecting the vulnerability of the people in need.

After we receive your information, one of the coordinators will send your prayer intention to the Prayer Ministers. Someone will follow up with you regarding your request in about 3 months, but you can email updates at any time. Requests are removed from the prayer list after 6 months. You are welcome to re-submit an additional request at that time.

Please know that you can submit your information without worry, as this is a secure site.
What is the name of person for whom prayer is requested? *
Please give us the first and last legal names if possible, for our follow-up. Full names will not be used on the prayer chain unless requested.
Your answer
Requested by: *
Please give us your first and last names.
Your answer
If you're requesting prayers for someone else, have you contacted them and received their permission?
This is not required, but is a helpful guide in choosing how to name them in the prayer.
Your phone number:
Your answer
Your email address: *
This is our preferred way of contacting you. If you don't use email, please note that below.
Your answer
Are you an Epiphany parishioner
Please note that we will be contacting you for a 3 month update, unless you update us before that time.
How should the recipient's name be listed on the written Prayer Request?
Your answer
Prayer Intention (How email text should read): *
For what specifically would you like us to pray for this person? ( E.g. healing from surgery; strength and comfort as they journey through a difficult time; patience and perseverance while looking for employment, etc.)
Your answer
Are you interested in serving as a Prayer Minister for the Prayer Chain?
If so, one of the coordinators will contact you for a short orientation.
Complete the following section only if the recipient of the prayers is a parishioner.
Community Care would like to follow up with parishioners in need, if that is welcomed.
If the recipient is a parishioner, do they desire and give their permission for their name to be listed in the bulletin for prayer?
Only parishioner's names are published in the bulletin. Epiphany must have the permission of the recipient or a close family member to do so.
If the prayer recipient is in a facility, please note the name below.
Your answer
Parishioner Prayer Recipient's Phone Number:
Your answer
Your answer
Address of home, hospital, nursing home or rehab facility:
Your answer
Parishioner Prayer Recipient would like:
Please check any that apply.
Parishioners will be sent a card from our Blessing Card Ministry, unless you request otherwise.
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