Appointment Request Form

Please fill out this form if you would like to request an appointment with Fr. Rafael Lavilla, and click submit.

Please complete and submit this form to request an appointment with Fr. Rafael Lavilla.

IMPORTANT: Please select or explain the reason for your appointment. All responses provided will be kept confidential.

Submitting the form does not guarantee you an appointment. You will be contacted as soon as possble after your request is received to schedule your appointment.

If this is a pastoral emergency, please call the office at 904-330-0153 and follow the prompts for the emergency line.

Thank you.

Contact Information

Name of Person Needing the Appointment

Name of person requesting the appointment if different from the person needing the appointment

This address will receive a confirmation email

Phone

Is the person who needs the appointment a registered parishioner of St. John Paul II Church?

Please select one option.

Yes No

Appointment Details

Reason for the Appointment

Please select all that apply.

Personal Pastoral Need Child in Crisis Marriage or Family Issue Other (Please specify below) SJPII Ministry Leader Meeting

If you selected Other for the Reason for the Appointment, please explain your need here.

Please explain the pastoral need and the urgency of the appointment.

Urgency of the Appointment

Please select one option.

High Urgency; Time-Sensitive Important, but not time-sensitive Not urgent

If you selected

Type of Appointment (Check both if either is acceptable)

Please select all that apply.

Phone Call In-Person

Description

Please fill out this form if you would like to request an appointment with Fr. Rafael Lavilla, and click submit.

Appointment Request Form

Description

Please Fix the Following