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Emergency Baptism

Emergency Baptism Form

PLEASE NOTE

In the case of emergency sacraments performed when in danger of death, the Sacrament of Confirmation can only be supplied by a Catholic Priest/Bishop. Please see Emergency Baptism/ Confirmation Memo for more information.

Emergency Baptism Form

Your Email

Hospital or Institution Name

Date of Baptism

Name of Baptized Child

Mother's Full Maiden Name

Father's Name

Born in City State

Birthday (Month, Day, Year)

Was the baptism performed according to the Rite of the Roman Catholic Church?

Yes No

Was an Emergency Confirmation performed by a Catholic Priest?

Yes No

Baptized By

Parents Permanent Address

Parent Phone No.

Name of Catholic Witnesses

Parents Email Address

As Recorded in the Sick Call Register of this Medical Center

PLEASE NOTE

In the case of emergency sacraments performed when in danger of death, the Sacrament of Confirmation can only be supplied by a Catholic Priest/Bishop. Please see Emergency Baptism/ Confirmation Memo for more information.

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