Mi Sheberach LeCholim Form
Dear Members and Friends:

In an effort to assure proper respect and decorum during the recitation of the Mi Sheberach LeCholim in the main minyan we ask that if you have names of ill individuals for whom you wish to have a prayer recited that you kindly submit the names by Noon, Friday using the form below, in advance of Shabbos.

Mi Sheberach for: *
Name *
Your answer
Mother's Name: *
Son / Daughter of
Your answer
Ideally any name provided should include the Hebrew name and mother's Hebrew name of the individual whom you would like included on the list. Where the Hebrew names are unknown the English ones will suffice. Where the mother's name is unknown but the father's name is available, it should be provided.

Names supplied to this list will be recited for two consecutive Shabbosim after which time they will be automatically removed from this list. At that time if you would like to maintain a name on the list please resubmit it on this web page.

We ask that you resubmit these names to assure that our list is accurate and that all those on the list are in fact in need of a Mi Sheberach prayer. All Mi Sheberach prayers from this list will be recited at the main minyan.

We of course recognize that there may be instances where people are unable to supply us with names prior to the aforementioned Friday noon deadline. We will still take names in person.

Thank you for your cooperation.

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