Skip to content
Children's Miracle Network at MCHS Foundation
September is NICU Awareness Month! Share your story with us.
1.
Were you satisfied with the care received in the Neontal Intensive Care Unit at MCH?
Yes
No
*
2.
What was your child's gestational age at birth (in weeks)?
(Required.)
*
3.
How long was your child's stay in our NICU?
(Required.)
1 week (up to 7 days)
Over 1 week (between 7-14 days)
1 month (30 days)
Other (please specify)
*
4.
Can you share your first and last name? Your child's name and your relation to the child.
(Required.)
*
5.
Do you stay in contact with your child's caregivers at MCH?
(Required.)
Yes
No
I want to
*
6.
Was there a nurse, doctor, or support staff that positively impacted your NICU journey? (If yes, please list their name)
(Required.)
*
7.
Are you comfortable being contacted by a member of the MCHS Foundation?
(Required.)
No
Yes, Please provide your contact information (phone number and email address)
*
8.
Would you be comfortable with our team sharing your story on social media in honor of NICU Awareness Month.
(Required.)
Yes
No
Please provide more information about this.
*
9.
Give us an update on your NICU baby! How old are they now? What do they like?
(Required.)