Request Dedication
Please fill out one form for each dedication. We add your dedication to our monthly Medicine Buddha puja, which is recited to remove obstacles. Your dedication will be removed from the list 3 months after submission, but you can add it by filling out this form again.

Contact for questions and cancellations:
Email address *
Your First Name *
Your Last Name *
Name and last name of the person to whom you are dedicating
Example: John Smith
Your dedication (good wish for that person)
Example: May she quickly recover after surgery
A copy of your responses will be emailed to the address you provided.
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