Prayer Request Form
Please fill out this form and click submit.
Contact Information
Name
Email
Phone
Are you a member of The Wells Life Church
Please select all that apply.
YES
NO
I'm interested in learning more
Prayer Request Details
(Please include as much or as little detail as you’re comfortable sharing)
How can we pray for you?
What type of request is this?
Please select all that apply.
Personal
Family
Health
Finances
Salvation
Deliverance
Direction/Wisdom
Other
Other
Is this an urgent request?
Please select all that apply.
Yes
No
Is this request time sensitive? (If so please explain)
Would you like someone from the Prayer Team to contact you?
Please select all that apply.
Yes, please reach out.
No, I just need prayer.
Do you give us permission to share this with the Intercessory Prayer Team?
Please select all that apply.
Yes
No-please keep this confidential with the leadership only
Thank you for entrusting us with your request. We are praying and believing with you for breakthrough and peace in Jesus’ name.
Submit
Description
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