Request a prayer visit

In addition to our pastoral staff, we have a wonderful group of team members that are committed to praying for you.
If you are having surgery, hospitalized or are desiring an in-person prayer visit, please fill out the form below.

First Name of Person Needing Prayer

Last Name of Person Needing Prayer

Is this person aware of this visitation request?
Yes
No

Does this person attend Cross Church?
Yes
No

Person's Age
Child
Teen
Adult
Sr. Adult (55 & Up)

Location (Include room number if hospitalized)

If hospitalized, how long are you expected to be in the hospital?

Best time to come?

Reason for Prayer Visit?

Contact Person's First Name

Contact Person's Last Name

Phone Number

Email

Do you attend Cross Church?
Yes
No

If you serve on a team, which team do you serve on?

If you are in a small group, which groups are you in?

Submit

Request a prayer visit

cross church

2600 coteau rd. Houma, LA. 70364

Phone: 985.262.3839