Request a Pastoral Visit
Please complete form below and submit.

If you would like a Chaplain to visit a patient in a Catholic Health Services Facility, please complete and submit the form below. Your message will be forwarded to the Pastoral Care Department, who offers this service, of the particular facility. If the message is other than a prayer or visit request, we will get back to you within 24 hours.

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