Hospital Visit Request

At Life United, we strive to share God's love and encouragement with everyone. If you or a loved one needs someone to visit them in a Shreveport/Bossier City hospital, please use the form below to request that a pastor or caring volunteer stop by to pray with them and share our encouraging support.

1. Patient Information

FIRST and LAST Name

(Patient must request or consent to the visit.)

2. Facility Information