Prayer or Contact Request

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Please reach out to us with any prayer requests or concerns you have as we are apart. All requests will be reviewed by our ministry staff and will remain confidential unless permission is given to share.

Your Name *

Phone

Concern or Prayer Request

Would you like to be contacted?

Be sure to provide accurate contact information above so we can reach out to you!

Yes, please have a ministry staff member contact me.

Yes, please have any staff member or volunteer contact me.

No, I do not need to be contacted at this time.

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Would you like your request shared with the church prayer team? *

In addition to the CrossRoads staff praying over your need, we often share the prayer requests with our prayer team. Please indicate below whether or not you would like this shared with that team.

Yes

Additional Comments

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