Prescription Joy Visit Survey
Prescription Joy is a healthcare clowning nonprofit based in New Orleans, founded in 2018

Did you have an interaction with our clowns? Tell us all about it, if you'd be so kind!

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Prescription joy made us feel: *
I would like to see Prescription Joy more often *
I would Recommend Prescription Joy to others here *
Did you have a good time with the clowns? Is there a story or anything you'd like us to know? What was your favorite part? (Can be filled out by legal guardian)
Narwhals or Unicorns? *
Finally, a little legalese, in case you'd be alright us with sharing your response!
If you said something about us, can we share your quote publicly? (legal stuff below)
*
(legal stuff from the question above)
Prescription Joy uses testimonials for the purpose of promotion, publication, marketing, fundraising, illustration, and/or advertising in any and all mediums (the 'Purpose'). Testimonials, such as yours, assist us in sharing with funders and the public what we do. We would like your permission to use anything you may have written herein for the Purpose, either attributed to you or anonymously, as per your preference. Should something you have written here be confidential, please use the box below to let us know what information is to remain confidential; we will never use anything shared with us in confidence and all such information will only be shared with Prescription Joy and our Representatives.

You can share this and tell people I said it!     Prescription Joy may use anything I have written here and attribute it to me with reference to my first name and the first initial of my last name. I hereby release Prescription Joy and its Representatives for all claims and liability relating to any statements made herein. I waive my right to any compensation.

You can share this, but don't tell people who said it     Prescription Joy may use anything I have written here with anonymity. Prescription Joy may not use my name for the Purpose, but it may use my testimonial. I hereby release Prescription Joy and its Representatives for all claims and liability relating to any statements made herein. I waive my right to any compensation.

Please don't share this with anyone else     I do not consent to Prescription Joy using anything I have written herein. I have provided the above information for internal use by Prescription Joy and its Representatives only.
I acknowledge that I am over the age of 18 or The Legal Guardian of a minor under the age of 18      *
Required
If you have any images or videos you'd like to share with Prescription Joy, please email them to: Info@PrescriptionJoy.org, OR:
By typing your full name below, you consent to the terms and conditions listed herein
Images designed by Chris Marroy
https://chrismarroy.com/art
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