When you share your prayer requests for yourself or for others, our pastoral care team will pray for you. You can also confidentially share your request by texting the word PRAYER to 716-226-3520.

Or, you can fill out whatever parts of the form below as would be helpful. We will be in touch.

Our Father… (Jesus, Matthew 6 & Luke 11)

And he told them a parable to the effect that they ought always to pray and not lose heart… (Jesus, in Luke 18)

Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God. (St. Paul, I Corinthians 1)

Name

First Name

Last Name

Prayer for:

Your relationship to the above:

How can you be reached?

Please enter your email or your phone number.

Hospital?

Millard Fillmore Suburban Hospital

Buffalo General

Roswell Park Comprehensive Cancer Center

Other

If other, please specify:

Date admitted:

YYYY

Would you like a visit?

Yes

Would you like to receive the Lord's Supper?

Yes

Please pray for:

If other, please specify:

Additional information: