Request for Inner Healing Prayer

LifePark members may receive a personal time of healing prayer. Each confidential session is guided by the Holy Spirit. Prayer ministers assist those seeking freedom from past wounds, lies and unforgiveness to usher in wholeness and freedom.

Name: * First Last
Birthdate * / MM / DD YYYY
Parent's Name (if application is for a minor): First Last
Email: *
Phone: * - ### - ### ####
I prefer to be reached by: *
Gender: *
Church you attend:
Please select from these options for your prayer session:
1st Monday of current month: 10:30 a.m. - noon 2nd Thursday of current month: 6-7:30 p.m. 3rd Tuesday of current month: 1-2:30 p.m. 4th Wednesday of current month: 6-7:30 p.m. None of the above times work for me
Please choose any/all that work for your schedule.
Have you received this type of prayer ministry in the past? *
Due to any sensitive areas we will be praying for, do you have a preference for gender of prayer ministers? *
Approximate date of past ministry: / MM / DD YYYY
Who referred you to this ministry?
Why would you like to receive an individual prayer appointment?