LMS Cholim Form
Please use this form to inform the synagogue and clergy of community members who are sick and in need of support. 
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English Name of Individual in Need of Recovery *
Hebrew Name of Individual in Need of Recovery
What would be helpful?
Relationship to sick individual (friend, parent, child, none, etc)
Contact info/visit address:
Please provide either the phone number or the address for the question above
Your Name *
Your Email *
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