Medical Facility Application

General Information

Which of the following apply to your department/unit? See questions below.

Patient Demographic Information

For each age group below, please list the average number of pediatric patients seen daily in YOUR unit/clinic. Please do not leave blank. Mark zero as it applies.

Sending Sunshine Items
Please note that the below requests are subject to the availability of Project Sunshine’s materials based on the number of hospital partners at any given time. You may receive shipments up to 4-5 times per year.

For Project Sunshine Programming

Use Ctrl button to select multiple programs.

Marketing and Social Media Consent

Additional Comments