Welcome to South Nassau

Request a Visit or Prayer

If you would like our Chaplain to visit a patient within the hospital or would like to submit an online prayer request for anyone in need of spiritual support during difficult circumstances, please fill out the form below and click submit.

Your message will be sent directly to our Pastoral Care department. Our hospital has a strict policy that we do not share personal information publicly. Only our Pastoral Care staff will receive your information and request. If your message is regarding something other than scheduling a visit or a prayer request, a member of our Pastoral Care Team will get back to you as soon as possible. Please make sure to include your contact information below for them to get in touch with you.

* - denotes a required field
 Required Information:
Please check your preference:
 Pastoral Visit Request  Prayer Request  Other
If other, please specify: 
* First Name: * Last Name:
* Patient Room #: * Patient Unit:
 Optional Information:
Do you wish to be contacted by our Pastoral Care Department?Yes  No
Your First Name: Your Last Name:
Phone Number: Email Address:
Additional Comments:

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