Once you register below, you will be able to submit your letter.
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| If you would like to learn more or prefer to submit your story by mail, please read our Frequently Asked Questions. |
Please provide your contact information so that we may follow up with any questions.
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| Parent First Name:* |
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| Parent Last Name:* |
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| E-mail Address:* |
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| Street Address:* |
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| Address Line 2: |
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| City / Province:* |
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| State:* |
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| Zip Code:* |
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| Country:* |
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| Primary Phone Number:* |
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| Child's Name:* |
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| Child's Date of Birth (mm/dd/yyyy):* |
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| Condition:* |
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| Yes, I agree to the release terms.* |
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Please provide your letter's greeting, body, and signature.
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If you need help getting started, see the sample letter.
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Greeting: Dear parent of
(i.e. "a child born with a heart not fully-developed") |
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Body:
(tell details of your experience)* |
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Signature:
Sincerely,
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Please review your story and click "Submit" to send it to us.
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| We may make minor grammatical or style changes to your story, and we may correct the spelling of names. |
| In some cases, we may need to verify medical information with an appropriate physician or his or her team. |
| If we have questions, we will follow up with you for clarification. |
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