Healing Room Prayer Request Form
Please fill out this form to request your individualized prayer session. We will contact you within 24 hours. In the meantime, please download the "Cisco WebEx Meetings" phone app. We will be praying with you over WebEx voice and video conferencing.
Name *
Your answer
Email *
Your answer
City and State
Your answer
Phone number (text message capable) *
Your answer
Gender
Age
Your answer
If under 18, name of parent/guardian with you during prayer:
Your answer
Church name & affiliation (if any):
Your answer
How did you hear about the Oasis City Church Healing Room?
Your answer
I need healing for: *
Your answer
Legal Liability Release
By submitting this prayer request form I affirm and agree to all of the following:

I am declaring that I am over the age of 18 or have express permission from my parent or legal guardian to receive ministry from Oasis City Church.

I give my permission to the Oasis City Church Healing Room volunteers to pray for any medical or emotional condition for which I ask for prayer and as described above on this form.

I hereby release Oasis City Church and their Healing Room Ministry, their volunteers and staff from any liability, harm or perceived harm resulting from my voluntary reception of free prayer on this and subsequent visits.

I understand that these healing rooms are staffed by volunteers. They are not trained or licensed professionals of counseling, therapy, nutrition or medical services.

I understand if I am currently taking medication or operating under the advice of a medical practitioner, therapist, counselor or any professional health service provider, I will allow said professional(s) to confirm any results of prayer received here today prior to altering any prescribed medical treatment for my condition(s).

I understand that this form and all data on it shall be the sole property of Oasis City Church, Westerville, Ohio.

I give Oasis City Church specific permission to use my name, testimony, age, gender, photos ,video and audio testimony for possible publication. Please note, your Healing Room prayer sessions are NOT recorded.
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