In the western churches, the Bishop usually administers the sacrament. At the beginning of the ceremony there is a general imposition of hands, the bishop meantime praying that the Holy Ghost may come down upon those who have already been regenerated. He then anoints the forehead of each with chrism saying, "I sign thee with the sign of the cross and confirm thee with the chrism of salvation, in the name of the Father and of the Son and of the Holy Ghost." Finally, he gives each a slight blow on the cheek saying, "peace be with thee". A prayer is then said so that the Holy Spirit may dwell in the hearts of those who have been confirmed, and the rite closes with the bishop's blessing.

The eastern churches usually omit the imposition of hands and the prayer at the beginning and accompany the anointing with the words, "the sign of the gift of the Holy Ghost." These several actions symbolize the nature and purpose of the sacrament: the anointing signifies the strength given for the spiritual conflict; the balsam contained in the chrism, the fragrance of virtue and the good odor of Christ; the sign of the cross on the forehead, the courage to confess Christ, before all men; the imposition of hands and the blow on the cheek, enrollment in the service of Christ which brings true peace to the soul.