JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Request a Mi Shebeirach
Please provide us the name (either English or Hebrew) of your friend and/or loved one whose name you wish us to include. We will keep the person’s name active on our list for a period of 3 months. After 3 months you may resubmit your request if you wish us to continue saying the blessing. In addition, please notify us if the name should be removed from the list earlier by emailing us
HERE
.
(Please make a separate submission for each person to be added to the list)
A prayer for those who are in need of a recovery. Mi Sheberach is customarily recited along with a pledge to charity,
as it beseeches G-d to spare the person from further suffering in the merit of the charity given on their behalf.
If you would like to make a donation, click
HERE
.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name of person who is ill in English
*
Your answer
Hebrew First Name of person who is ill (if known)
Your answer
Hebrew First Name of Mother of person who is ill (if known)
Your answer
Relationship of the ill person. Check all that apply
TBE congregant
Immediate family member of TBE congregant
Other relative of TBE congregant
Friend of TBE congregant
My first and last name
*
Your answer
My email
*
Your answer
Would you like Rabbi Pardo to contact you?
*
Yes
No
Is there any additional information you would like us to know?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
