O Most Holy Immaculate Virgin, Fount of Mercy, I turn to You with faith and tenderness to tell You that I want to love You and honour You always.
Being nothing more than the most abject of sinners, I have need before all else of mercy, and for this, I turn to You, You who are the Font of Mercy.
I beg You, give me your mercy, cover me with your mercy, conquer me with your mercy, and then, if it so pleases You, grant me the grace that I petition You with such ardor ( here mention the grace or favour requested )…
All of this I must and commend to your Immaculate Heart and to this your Heart I abandon myself without reserve and with all my soul.
O Holy Immaculate Virgin, Fount of Mercy, protect me, help me, save me. Amen.

1Our Father, 1 Hail Mary, 1 Glory Be….