NICU Wall of Hope - Tri-City Medical Center

Tri-City Medical Center is developing a Neonatal Intensive Care Unit (NICU) Wall of Hope to share amazing stories of those individuals and families who have overcome early challenges to inspire hope. If you or a family member is a graduate of the NICU at Tri-City Medical Center, we’d love to share your story!
Those selected for inclusion will have their image and biography included on the Wall of Hope and will participate in a photography session. Fill out the form below to tell us your story for a chance to be included in our NICU Wall of Hope!

The photoshoot will take place on Thursday, November 18th

NICU Wall of Hope Form

Parent or Guardian's Name

First Last

Former Patient's Name

First Last

Contact Information

If former patient is under 18, please provide the parent or guardian's contact information:

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of birth

Current age

Gestational age at birth

Birth weight

About You

Let us know about you or your child's experience in the NICU.

How long were you in the NICU?

What challenge did you overcome in the NICU?

What was recovery like after leaving the NICU?

What would be your best advice for another parent or guardian who has a loved one in the NICU?

What are your favorite hobbies

What do you do now? (school, job, activities, etc)

What is your current career goal?

What is something you are proud of yourself for accomplishing?

Please upload a photo of when you were a baby in the NICU or around that time.

Max. file size: 200 MB.

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