Care Requests

Please fill out this form and click submit.

At Leander UMC, we don't want anyone to walk through life's hard seasons, or its joyful ones, alone. Use this form to let our Care Team know about a need for yourself or someone else. Your information will be kept in confidence.

Your Name

*

Your Phone Number

*

Is this request for you or someone else?

*

Please select one option.

Myself Somone Else

Does this person know you are submitting this request?

*

Please select one option.

Yes No

If you are submitting this request on behalf of someone else, please notify them that you have submitted it.

(If you'd like for this prayer request to be anyonymous, just type Anonymous or N/A in the name bar)

How can we be in prayer for you?

*

How long would you like for this to be on the prayer wall?

*

Please select all that apply.

1 week 2 weeks 6 weeks Indefinitely None- clergy witness only

Would you like for the pastor to contact you about this? If so, please enter your contact info below unless you are already in our directory.

Please select all that apply.

Yes No

Phone

Email

Description

Please fill out this form and click submit.

Please Fix the Following

Close