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REQUEST FOR VISITATION OF THE SICK

To Request That a Nurse Visit the Sick or Injured Please Complete the Form Below & Select Submit

Your Name:   

Are you a member of Family Faith Center?

Select the location of the visitation:



What is the address of where the visit should take place?  Please be sure to include Room numbers or Apartment Numbers.





Describe the reason for the visitation:





Is the visitation for someone other than you?

If yes what is your relationship to the person who needs the visit?


Please provide your contact information below so that we may schedule the visit:


What is your address?





What is your phone number? 


What is your e-mail address? 



To Complete Your Request Select Submit


To Clear the Form and Begin Again Select
Use the form below to request that a member of the Gate Called Beautiful Pay a Visit to Someone Ill or Injured. When you have completed the form select Submit to send your request to the Parish Nurse.

We praise You, O God,
Healer of the sick.
O God, who blessed our ancestors,
Abraham, Isaac and Jacob;
Sarah, Rebekah, Rachel and Leah, send Your blessing to these sick ones

Have mercy on them, and graciously
restore their health and strength.
Grant them a refu-a sheleima; a complete recovery,
along with all others who are stricken.
May healing come speedily, and let us say:
Amen.







Mi SheBerackh Prayer
or
Jewish Blessing for Health and Healing
Traditional Transliteration
YESNO
YESNO