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Hospital Visitation Request

This ministry involves the spiritual care and emotional support to the sick and their loved ones during hospital and home visits. Its goal is to help the hospitalized grow in Christ through encouragement and prayer, while finding assurance through the support of the LRUMC family.

Please complete the form below to request visitation: 

 

 
Contact's Name*
Email Address
Patient's Name*
LRUMC Member/Attendee?
If no, describe affiliation with LRUMC:
Hospital Name*
Room Number
Reason for Admittance:
*