Be Good Saint Dymphna, great wonder-worker in every affliction of mind and body, I humbly implore your powerful intercession with Jesus through Mary, the Health of the Sick, in my present need… (mention intention here)
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Saint Dymphna, martyr of purity, patroness of those who suffer with nervous and mental afflictions, beloved child of Jesus and Mary, pray to them for me and obtain my request.

Our Father…
Hail Mary…
Glory …