How Can We Help You?

HOME VISIT

Our Lady Queen of Peace provides pastoral care to parishioners who are homebound, sick, hospitalized or have other special needs. To request this service, please fill out the Home Visit form below or contact (337) 233-1591 for more information.

Home Visitation Request

Are you making this request for yourself or someone else?*
- Myself
- Someone else
Name of Individual Making Request:*
First Name Last Name
Email of Individual Making Request:*
Contact Number of Individual Making Request:*
Name of Individual Needing this Visit:*
First Name Last Name
Address of Visitation:*
Street Address Address Line 2 City State
Leave any additional information in the comment box below: