#IamCHFM - Share your story with us!

 

Thank you for your willingness to share your child’s health story. Our team at the Foundation feels honoured to learn more about the children we support. Please fill out and submit the form below and our Foundation Family coordinator will follow up with you.

  Parent/Guardian Name:

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Name:

 

 

   

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  Child's Name:

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Name:

 

 

   

 

Date of Birth:

 

If you respond and have not already registered, you will receive periodic updates and communications from Children's Hospital Foundation of Manitoba.


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(Maximum response 255 chars, approx. 5 rows of text)

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   Please leave this field empty