The Gift: Poems to Order Intake Form

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If you or someone you know is part of the organ transplant community—as a recipient, donor, family member, caregiver, medical professionals, etc— O, Miami would like to provide a small way to honor them through a poem.

O, Miami is collaborating with Jackson Health System and Miami Transplant Institute on an original poetry and storytelling project called The Gift (working title). As part of that project, we are offering individuals touched in some way by organ transplantation the opportunity to have a poem written by a South Florida poet, free of charge.

To request a poem, provide us with a few details about the individual’s life, their passions, or any other personal details which best characterize them. O, Miami will pass that information onto a poet, who will compose an original poem in honor of your loved one.

Requestor's Name *

Requestor's Email *

Honoree's Name *

Details about honoree, examples include: favorite pastime, nickname, a fond memory, personal traits (ie, good sense of humor), where they grew up, etc
*

Preferred language for the poem *

English

Spanish

Creole

French

Portuguese

Which of the following is a South Florida resident? *

The requestor

The honoree

Both

Please add requestor and/or honoree's 5-digit South Florida zip code. *

Do you wish for the requestor of this poem to remain anonymous? *

Yes

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