Share Your Story with Me Fine
You can help Me Fine raise funds and provide support to other families! Your voice is the best tool for us to help other families during their child's medical treatment. Sharing your story is optional and will not affect Me Fine's support for your family.
Use the space below to share your family's story.
Some ideas to get you started:

- What did life look like before your child's diagnosis? How does it look during and after?
- What do you wish other people knew about having a child with a critical or chronic illness?
- What costs, not covered by insurance, have surprised you or impacted your family the most?
- How can people support families in situations like yours?
Family Information
Confidential unless checked below
Your Name
Child's Name
Child's Age
Child's Diagnosis
Hospital
Clear selection
Hometown
Phone
Alternate Phone
Email Address
Preferred Contact Method
May We Contact You For...
YES, I allow Me Fine Foundation to share:
Release of Information
I give permission to Me Fine Foundation to share my story as part of its community outreach and fundraising. This may include Me Fine's website, social media, traditional media, grants, or communications to supporters.

I understand that this has no impact on any referrals to Me Fine Foundation for my family.

I understand that I can change my mind at any time by writing to Me Fine Foundation:
318 Blackwell St, Ste. 130, Durham, NC 27701, or by email at: info@mefinefoundation.org
Electronic signature - type full name below *
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