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Last Rites Request

- Requests

This online request is for True Emergencies ONLY. True Emergency stands for a situation where the person is in a state of passing.
Assisting the dying with our presence and prayers is an act of love that is imperative for us Christians. Thank you for requesting this spiritual assistance in the last moments of life of your loved ones.
online request form:
This form is not accepting responses at this time.
- Name of the terminally ill person REQUIRED Please fill out this field. Please enter valid data.
- Is he/she a member of our Parish? REQUIRED Yes No Please fill out this field.
- The home address, hospital or nursing home where the terminally ill person resides determines which Parish they belong to. If the person belongs to another Parish, please, contact their Parish Priest first. See are our Parish boundaries by clicking on the image below.
  I Agree Please select this field.
- Address (Provide the necessary additional information if he/she is stationed at a hospital or nursing home) REQUIRED Please fill out this field. Please enter valid data.
- Contact's Full 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.
- If necessary, please provide some information about this person, which you think will help us meet them in their situation (i.e.: state of unconsciousness, religious background, etc.)
- Is this a True Emergency? No Yes
- If the person is still conscious, requests Holy Communion and is able to swallow the Body of Christ, then the Priest will give Communion as a Viaticum.
  I Agree Please select this field.
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Rancho Cordova, CA

St. John Vianney Parish

Last Rites Request

online request form: