Request Prayer The information submitted on this form will be shared with intercessory prayer groups at the International House of Prayer Missions Base. By filling out this form, you acknowledge your consent for any information you give to be shared with the intercessors and you acknowledge that it will not be kept confidential. This form is only to be used for prayer requests for physical healing. Prayer requests: email@example.com Name Phone number Email Verify email What is your prayer request? Need assistance with this form?