Request Pastoral Care

Thank You For Reaching Out For Pastoral Care!

Pastoral care is the way we, as a Catholic community, stand in faith and compassion beside one another along life's journey, especially during times of transition, illness, or loss.

Please tell us which is your home church or organization you represent REQUIRED Our Lady of the Assumption Saint Maria Goretti Other... Please fill out this field.

Type of Pastoral Care REQUIRED

Please check all that apply.

Friendly Check-in Visits Communion Visits Reassurance Calls Prayer Shawl Request Pick-me-up Gifts/Flowers Prayer Intention Nursing Home/Hospital Visit Other... Please fill out this field.

More Information

Please provide any additional information that we should know.

I would like this name published on our prayer list Yes No

Name and Contact of the Person in Need of Pastoral Care

Name Please enter valid data.
Email Please enter an email address.
Phone Number Maximum 20 characters Please enter a phone number.
Address Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Are you requesting this for yourself? Yes No