Prayer Request
“Devote yourself to prayer, keeping alert in it with thanksgiving.” – Colossians 4:2
Circle One: *
Is this a public prayer request or a private prayer request? *
According to the HIPPA law that protects the privacy of health information, the person for whom we are praying publicly needs to give permission for their full name and/or situation to be listed in our bulletin, newsletter, and prayer journal. If you do not have the individual’s consent for public prayer, continue to pray privately or in confidence with the pastor, church staff, and other trusted people.
Please Pray For: *
Please include NAME & REASON. (See note above regarding HIPPA Laws)
Your answer
Please Keep on Prayer List for: *
All names are automatically removed at the end of the time requested. A new form must be filled out for additional time. If no time is requested, the name will be removed after 2 months.
Should we send this person a note of encouragement?
Mailing Address
Your answer
Your answer
Your Connection to Person for Whom We Are Praying: *
Examples: self, friend of ____, father of ____
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms