Prayer Requests
Are you feeling troubled or overwhelmed?
 
 

Please allow us to help you in this time of need through the power of prayer!

The only required field below is the prayer request itself and your request will be sent directly to the pastor.

In some situations such as hospitalization or public release of information, you will need to have a signed HIPAA form on file in the church office.

You can download the HIPAA form HERE [pdf].
413-782-6856 (fax)

 
 Prayer Request  
Request Details:
(required)
 
 Contact  
Your Name:
Your email address:
Telephone:
Comments:
 
 Medical  
Diagnosis:
Hospital Name:  HIPAA
Room Number:
 
 Distribution  
Pastor Chris Only (private)
Pastor Chris and Church Deacons (limited)
Prayer Team (limited)  what's this?
Congregation (public)  what's this?  HIPAA
copyright 2005 | Church in the Acres | Springfield, Massachusetts