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Private Prayer Request Form Template

Easily Collect and Manage Prayer Requests Online

Are you looking for a simple way to gather prayer requests from your community? This private prayer request form template helps churches and individuals effectively collect and organize heartfelt prayer needs, ensuring that everyone is heard. Benefits include easy customization to align with your brand, mobile-friendly access for users on any device, and secure data handling for confidential requests. Start connecting with your community by using this live template today.

Full name
Email
Phone
Preferred contact method
Email
Phone call
Text message
Who is this request for?
Myself
Family member
Friend
Colleague/classmate
Community or organization
Prefer not to say
Other
Please Specify:
First name or initials of the person (optional)
Prayer topic
Please Specify:
Describe your prayer request
How urgent is this request?
Not urgent
Soon (within a week)
Urgent (within 48 hours)
Immediate (today)
Prefer not to say
How long would you like us to pray for this request?
One time
One week
Two weeks
One month
Ongoing
Not sure
How should we share this request?
Private to pastoral/care team only
Share anonymously with prayer team
Share with first name only
Share publicly with community (first name only)
Prefer not to say
Is it okay to mention any names you provided?
Yes
No
I have permission to share this information or it is my own information.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
Would you like someone to contact you for care or support?
Yes
No
Type your full name as your signature
Date
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Paper art illustration showcasing a private prayer request form template for FormCreatorAI article

When to use this form

Use this confidential form when someone needs prayer but does not want their request shared broadly. You can share it on your website, in small groups, and during hospital or counseling visits. After livestreams, pair it with the Online worship attendance form to offer a gentle next step. Pastors and care teams get the context they need to pray specifically, follow up, and schedule visits. This simple prayer request template guides people to share only what they choose and set privacy levels and contact preferences. For public praise or community intercession, direct people to the Prayer request form instead. The result: timely prayer, compassionate care, and fewer details slipping through the cracks.

Must Ask Private Prayer Request Questions

  1. What would you like us to pray for?

    This open-ended prompt lets you share the situation and the outcome you hope for. It helps leaders pray specifically while respecting the level of detail you are comfortable giving.

  2. How confidential should we keep this request (pastors only, care team, or share first name only)?

    Privacy choices build trust and prevent accidental oversharing. They also route your request to the right people for care.

  3. How can we reach you for care or updates (name, email/phone, best time)?

    Contact info ensures timely follow-up, prayer, and support. If your details changed, update them via the Church membership renewal form so we do not miss you.

  4. Is there a key date tied to this request (surgery, court date, exam)?

    Dates help us pray at the right time and schedule visits or check-ins. They also let us prioritize urgent needs.

  5. Would you like practical support in addition to prayer (meals, rides, visit, benevolence)?

    This clarifies the kind of help you want so we can mobilize the right team. It sets expectations and speeds real-world care.

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