Physical Healing Request

PURPOSE

The purpose of this form is to request Physical Healing from Bread of Life.

If you are hurting or you have a physical problem, sickness, or disease in your body, prayer can heal you.

Receive prayer to change your diagnosis, erase symptoms, and rewrite the outcome so you are healed and made whole.

Please complete this questionnaire to request Physical Healing.

DISTRACTION FREE NOTICE

To ensure a peaceful and distraction-free environment for everyone during the prayer session, we kindly ask that you make arrangements for your children beforehand, as childcare is not available. If you have someone accompanying you, they are welcome to wait in a separate prayer room during the session. Thank you for your understanding and cooperation!

CONFIDENTIALITY NOTICE

The information you provide will remain confidential and will be used solely to help us plan and prepare for your session. Only those involved in organizing your ministry team and members of your prayer team will have access to it.

DUTY TO WARN/DUTY TO NOTIFY NOTICE

We may disclose information without your consent to prevent you from harming yourself or others. We are legally required to report ongoing domestic violence, and abuse or neglect of children, elderly individuals and people with disabilities, including human trafficking.

LIABILITY RELEASE NOTICE

We will ask you to sign a Liability Release before your session. This is a legal agreement that protects us from being held liable for any injuries, damages, or losses incurred by you during your prayer session.