Nicklaus Children's Hospital, formerly Miami Children's Hospital
Local: 305-666-6511
Toll Free: 800-432-6837
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Welcome to the Miami Children's Hospital Success Story Submission Page

Fields marked with an * are required.

Your Name (First, Middle, Last) *

Email *

Patients Name (First, Middle, Last) *

Address, City, Zip, State *

Day Time Phone Number: *

Cell Phone Number

Name of the Doctor that treated the patient

Year(s) you or patient was treated at MCH

Tell us your Success Story *

Do you have photos to share with us? Send us a before photo.

After photo:

Consent disclosure *

Would you like to be contacted by the MCH Foundation? *

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 Marketing Department of Miami Children's Hospital and Miami Children's Hospital 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.