Is your NICU interested in partnering with The Superhero Project to support your NICU families? Thank you for your interest in speaking with The Superhero Project regarding the possibility of partnering with us to support your NICU families through our programs. We receive many requests for our support from NICUs throughout the country, and unfortunately, we are not able to partner with every NICU that reaches out to us. In an effort to learn more about your NICU and your interest in partnering with us to launch our programs to support your NICU families, we request that you provide responses to the below questions to allow our Board of Directors to review and determine if we may be able to partner with your NICU. While we are unable to respond to every request, we will contact you to set up a time to discuss your request in greater detail if we think we might be able to offer support. Name(Required) First Last Title(Required) Email(Required) Phone(Required)Hospital Name(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Hospital/NICU Website(Required) Number of Beds in NICU(Required)Annual NICU Census(Required)Please list the name and contact information for a NICU leader (NICU nurse manager, medical director, etc.)(Required)Please list the name and contact information for a NICU social worker and/or Child Life Specialist (if any)(Required)Please list the name and contact information for your hospital’s Foundation contact that supports your NICU (if applicable)(Required)Do you have a NICU Parent and Family Advisory Council?(Required) Yes No Would we be able to connect with them to share more about our programs?(Required) Yes No Other Which of our programs are you interested in bringing to your NICU?(Required) PJs with a Smile Wrapped in Love Kelly's Kloset Lullabies of Love NICU Graduation Packages NICU Welcome Packages AngelEye cameras Do you have several former NICU families who would be interested in leading our efforts to support your NICU?(Required) Yes No Would you be able to connect us with them if we are able to partner with your NICU?(Required) Yes No Other Many of our programs require volunteer support from time to time, such as assembling packages and delivering them to the NICU, and this is a great way for families to give back to your NICU. Please tell us why you feel The Superhero Project would be a good partner for your NICU.(Required)What impact are you looking for us to make at your NICU?(Required)Is your hospital or hospital’s Foundation interested in being a sponsor or providing some funding to help sustain our programs supporting your NICU families?(Required) Yes No Other Please list other nonprofit organizations that provide support to your NICU and what support they provide(Required)Is there anything else you would like to share with The Superhero Project?How did you hear about The Superhero Project?(Required) Δ
