Online Prayer Request
Please complete form below and submit.

Our online prayer requests are for anyone in need of spiritual support during difficult circumstances. By offering a prayer community, the collective result provides a powerful healing source and form of comfort for those experiencing difficulties in life.

We do not share personal information publicly. Only our Pastoral Care staff will receive information.

Your Name (*)
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Your Email Address (*)
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Patient's First Name (*)
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Patient's Last Name (*)
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Faith Group (optional)
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Room Number (*)
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Additional Comments
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Enter the 4 letter code (alphanumeric), as it appears, in the box. Enter the 4 letter code (alphanumeric), as it appears, in the box.
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1000 Montauk Highway
West Islip, NY 11795

phone 631.376.4444

A Magnet® Designated Hospital