Hospital Waiting List Registration
If your hospital has not registered with the program
and you would like to be included, please register on our waiting
list by filling out the form below.
One of the principal requirements to be eligible for the program
is an established infant loss Bereavement Program to
assist the parents of early infant loss.
Your program needs to have established procedures and follow
up for the parents while they are in the hospital and afterwards
in order to assist them with grief handling.
The Memory Box Program is only there to help with grief counseling
by giving the parents something special to hold what few mementos
of the lost child.
These boxes are not for use in other programs or losses. They
are made by volunteer artists who do all the work and cover
their expenses for supplies and shipping in order to offer support
and comfort to parents who normally leave the hospital with
heavy hearts and empty arms.
It can take several months until we may be able to add your
hospital to our active database, it depends on our volunteers
and their ability to cover the expenses of the program.
Please fill out the following information and
* = Required Fields