Share Your Grateful Patient Story - Charlotte Hungerford Hospital Philanthropy

Grateful Patient Program

Share Your Gratitude

Share your excellent Charlotte Hungerford Hospital experience with us! This form allows you to share your grateful patient story or simple message of gratitude for a Charlotte Hungerford Hospital department, physician, nurse, volunteer, or colleague who made a difference in your life or that of a loved one.

Name(Required)

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

Share Your Gratitude: Please share your grateful patient story or message of gratitude. Be sure to name specific departments or individuals who inspired you to submit your story.(Required)

Do you wish to remain anonymous?(Required)

No, you can share my name

Yes, I wish to remain anonymous

Can Charlotte Hungerford Hospital reach out to you about publishing your story?(Required)

Yes, Charlotte Hungerford Hospital may follow up for additional information and permission to publish my story

No, I do not wish to be contacted about my story