Prayer Request and Pastoral Care Form

Prayer requests submitted on Saturdays after 12 noon (CT) will not be included in that weekend's Prayers of the Faithful, but would be included for the following weekend.

Person Making the Prayer Request


My connection to The Basilica:

Information for the Person(s) in Need of Prayer


Field Is Required The person in need of prayer is my: (Select one of the available choices or enter a different value.)
(Maximum response 255 chars, approx. 5 rows of text)
Field Is Required What is this person's connection to The Basilica?

What is this person's prayer need?

Illness
Requests Visit?
(Maximum response 255 chars, approx. 5 rows of text)
Deceased
Date of death:
Are there other bereaved family members that belong to The Basilica?
(Maximum response 255 chars, approx. 5 rows of text)
(Maximum response 255 chars, approx. 5 rows of text)
(Maximum response 255 chars, approx. 5 rows of text)

How shall we pray for this person?


The person making this request asks that we pray for this person through:
(Maximum response 255 chars, approx. 5 rows of text)
Field Is Required Do you have the individual's permission to mention his/her name publicly?
(Maximum response 255 chars, approx. 5 rows of text)
   Please leave this field empty