Request Communion

- The Eucharist: Food for the Journey
  The Eucharist is our food for the journey—nourishing us through our earthly lives as we grow in communion with God and with the Church. The celebration of the Eucharist is the source and summit of the entire Christian life.
  Gathering as a parish community for the Holy Sacrifice of the Mass, especially on Sundays, is the high point of our relationship with God and with one another.
  However, illness, injury, or advanced age can sometimes prevent members of our parish from attending Mass in person. When this happens, arrangements can be made to bring Holy Communion to you at home or in a care facility through one of our trained lay Extraordinary Ministers of Holy Communion.
  If you or someone you know is unable to attend Mass and would like to receive Holy Communion at home or in a care facility, please complete the request form below. A member of our ministry team will contact you as soon as possible.
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  Your Information (Requestor)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email Please enter an email address.
  
  Parish REQUIRED Please fill out this field.
  
  Contact Information for Scheduling Holy Communion (if different from above)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Recipient Information (Person Receiving Communion)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Home Address REQUIRED Please fill out this field. Please enter valid data.
  
  Is this person Catholic? REQUIRED Yes No Please fill out this field.
  
  Do they live alone? REQUIRED Yes No Unsure Please fill out this field.
  
  Do they have any special needs or health concerns we should be aware of? (e.g., mobility issues, memory care, medical equipment) REQUIRED Please fill out this field.
  
  Are there pets in the home? REQUIRED Yes No Please fill out this field.
  
  If there are pets, please describe:
  
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St. Mary of the Snows | St. Peter | Resurrection

Mansfield, OH

Request Communion

The Eucharist: Food for the Journey