Success Story

Fill out this form to share your patient success story with us.

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When you submit this form you will receive an automatic reply confirming we have received your informaiton.

Thank you for sharing your success story with us!

Consent Disclosure:

By submitting your personal information and success story to Miami Children's Hospital, you have given consent for your story to appear on / and may appear in radio, television, newspaper, magazines, hospital publications, advertisements, press releases, media stories and/or other marketing efforts of the Miami Children's Health System Marketing Department and Miami Children's Health Foundation. I understand that in giving this approval that it is valid in perpetuity unless I submit a written letter to the Marketing Department discontinuing the undersigned. I shall receive no compensation or other gifts/payments for any of the above.