Share Your Baby’s Story

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Parent Contact Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
HRH Baby Information
Hospital affliiation*
- AdventHealth Tampa (formerly Florida Hospital)
- HOAG Newport Beach
- Johns Hopkins All Children's Hospital
- Mease Countryside
- Sarasota Memorial Hospital
- St. Joseph’s Women’s Hospital
- Tampa General Hospital
Full Name(s)*
Gestational age at birth*
Birth Date*
Favorite book or toy*
Nickname(s)
Family Story
Please provide a brief summary of your family's story.
Select all that apply*
- I was on hospital bed rest
- My baby was in the NICU
- I received a HRH Bed Rest Basket
- I received a HRH NICU Napsack
List your pregnancy complication(s.
Did HRH's outreach help your family? Please explain.*
Would you be interested in being a mentor to others in a similar situation?*
Please tell us your story*
Upload Photos*
Upload photos of your time spent on bed rest, your baby in the NICU, your baby today, and/or photos of your happy family. (8mb max file size)
Drop files here or

Accepted file types: jpg, png, tiff, jpeg, tif.
Photo Release*
- I agree to the Photo Release (please read).
Name
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High Risk Hope, Inc. (FEIN: 27-5129716, FL registration number: CH34727) is a 501(c)(3) publicly supported nonprofit organization. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (1-800-435-7352) WITHIN THE STATE OR ONLINE (www.FloridaConsumerHelp.com). REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.