Hospital Reminder

Aug 1

For Emplify & Mayo:

Our goal is to visit each member at the hospital. It is important that you or a family member contact us directly at the church office, either by calling 608.783.2236 or by filling out the form below.

Neither hospital gives out information regarding who is hospitalized.

Name of Hospitalized

First Name

Last Name

Name of Person Filling out Form

If different from above

First Name

Last Name

Email (of best contact)

If you want a response via email

Phone (of best contact)

Mobile preferred

(###)

###

####

Hospital

Emplify (formerly Gundersen)

Mayo

Other (include in message below)

Room #

Message

Additional information regarding hospitalization

Prayers

Check all that you desire

Include pastors

Include on prayer slides

Include on prayer board and in prayers of intercession during worship

Include first name only, no other details

Andrew Stutesman

Communications and Marketing Coordinator

Hospital Reminder

For Emplify & Mayo:

Sign Up Genius

Announcements for Sunday, Aug 3, 2025