Family Story Form
Month/Year you stayed at Hospitality House
What best describes you during your time with Hospitality House?
I stayed at Hospitality House
I was the Primary Caregiver of my patient
I was a patient receiving care
Miles from home
Relationship of loved one receiving inpatient/outpatient care
How many days have they been hospitalized?
What type of treatment are they receiving?
My biggest worry is...
Hospitality House has provided me with...
Without Hospitality House, I would have spent $_______ on lodging/meals
Without Hospitality House, I would have spent ____ nights sleeping in a waiting room/hospital chair
What has been the best/most helpful aspect of staying at Hospitality House?
What would you say to encourage other families facing a medical crisis?
What would you say to the people that make Hospitality House possible (donors and volunteers)?
What does "Hospitality" mean to me...
Please tell us in detail about your family story:
Should be Empty: