Remote Spiritual Healing Prayer Request Form
By the Blue Ray Remote Spiritual Healing Circle of the ChristoCentric Meditation Group, https://www.facebook.com/christocentricmeditation/ or http://www.christocentricmeditation.com
Notes on our processes and privacy policy
We do not charge nor solicit any fees for any of our spiritual healing prayer service. Our Spiritual Healing process is ChristoCentric. We do it remotely, that is the Group healing circle will not be with you personally in the same room or space. You don't have to go in-person into our venue or healing session. So in order to be able to do our remote healing prayer, we need your real full name, location, and condition to act as an "energy signature" much like an I.P. address so that divine healing energies can flow to your personal space (much better if there is a photo, but this is not required). Your consent or the consent of the person receiving spiritual healing is very important to us. We may also spiritually remote probe your spiritual being if we discern that there is a need to determine a deeper spiritual cause of the illness. You or the person will be included for 1 month in our remote group healing circle, and also in each of the member-healers' daily personal prayer. All the personal information you submitted will be treated with confidentiality and privacy. They will never be published, sold, or given to anyone outside of the Healing Circle. We may email you for clarification or feedback to help us assess the effectivity of our system for further improvement. We require contact information just to make sure /or verify that this is a serious request, and not form spamming by bots. We will not sell, spam, or solicit anything from you. If you feel that our healing prayer helped you, you might give us a testimony so that it can inspire others to have faith in the healing power of the love of the Lord Christ or be encouraged to volunteer as healers too. Privacy policy Statement here: http://www.christocentricmeditation.com/privacy-policy.html
Name of person needing healing prayer
*
First Name
Last Name
Your age group
*
1 - 18 yrs old
19 - 38 yrs old
39 - 60 yrs old
61 to 75 yrs old
76 and older
Location
*
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Are you the actual person needing prayer?
*
Yes
No, I'm a family member/ friend
If NO, did the person who needs the healing prayer give express consent or permission?
Yes, there is consent
No, I did it on my own
If NO, what is the reason why the person did not give consent?
The person is not conscious
The person is from far away and cannot be contacted
The person consented but has no access to the internet; I'm just helping out to send this request form
The person is a minor, and as a parent or guardian, I'm requesting this
The person will not approve of this kind of healing prayer (Then you should respect the person's wish)
Other
Describe the spiritual, mental, emotional, or physical condition you are requesting us to pray for:
*
Phone or Mobile Number
*
Please enter a valid phone number.
Your email address
*
example@example.com
Submit
Should be Empty: