Quesnel Healing Rooms - Prayer Request Form
We look forward to praying with you!

The Healing Rooms will be booking appointments for prayer sessions taking place on Mondays 7-8:30pm.

Please read the following so you can be prepared for your appointment!  You can receive prayer in one of three ways: in person at 263 Reid Street or by phone (audio or video call) or via Zoom. Please state your preference in the form.

After you complete and submit this form, you will receive an email inviting you to a Zoom call. Click on the link in the email to enter the meeting room. If you're using your phone, you will need to download the Zoom app. If you're using your computer, you can enter the meeting room directly from your web browser. Please be advised that your email invite will be sent as soon as the team is ready for you.

We love the phone too! We are happy to call you on the phone if you prefer!  Once your form is submitted, please keep your phone nearby. Our team will call you on the phone number provided when they are ready for you. Please note that you will be called sometime (between 10am and 12pm on Saturday.) state the time

In Person
You will be contacted with a time to come to the ministry location at 263 Reid Street, Monday evenings between 7:00-8:30pm.

Be expectant! God is in a good mood and He loves you all the time.

*If we receive your request outside of regular Healing Rooms hours, we will be in touch with you to arrange a different time for a call. Please give an indication of your availability if you can.

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Email *
Have you received prayer ministry at a Healing Room before?
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First Name *
Last Name *
Phone number *
Please state your preference *
Age (under 18s must have express permission from by their parent/guardian) *
Briefly explain your prayer request? E.g. "My grandma, Diane, has been diagnosed with Parkinson's" or "My ankle still hurts from an accident 12 years ago." *
Pain or symptom level *
No pain
Excruciating Pain
Please watch this 5 minute video from Bethel Healing Rooms
Please confirm you were able to watch the video. *
I, the undersigned do hereby release Quesnel Healing Rooms, their volunteers and staff from any liability, for any harm or perceived harm resulting from my voluntary receiving of free prayer on this and subsequent online or in person visits. I understand that this Healing Rooms is staffed by volunteers representing the broad body of Christ and reflect many denominations and churches. They are not trained or licensed professionals of counselling, therapy or medical services. I understand that if I am currently taking medication, or operating under the advice of a professional service, I will allow them (my medical doctor, therapist, counsellor etc.) to confirm any results of prayer received before altering any prescribed course of action. I understand that this form and all data recorded on it is the sole property of The Quesnel Healing Rooms. All content will be held in confidence for the sole purpose of ministry to the above unless when prohibited by Canadian law (disclosure of harm to self, harm to others or animals, abuse of a minor, court ordered request for records).I understand all email correspondence does not warrant the security of confidential material that becomes insecure because of actions that clients or unknown third parties may take or that is a result of software or of the internet server used by this Healing Rooms. While we strive to protect clients’ personal information, no data transmission over the internet is guaranteed to be 100% secure. Thus, we cannot ensure or warrant the security of any information during online transmission (i.e. email, video). Clients submit information and receive ministry online at their own risk. Quesnel Healing Rooms shall not be held responsible for damage or loss of any kind due to client’s use of software. We disclaim all responsibility or liability for any damages caused by viruses. By accepting the Healing Rooms ministry phone call or video session or prayer in person and indicating "Yes" below, I am confirming I understand and agree to the above disclaimer.     *
A copy of your responses will be emailed to the address you provided.
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