In this section, we will be asking you questions about your child. Please answer the question to the best of your ability. Please be sure to give as much detail as possible. This will help us write a beautiful story to go along photos. Be as emotional and personal as possible! If you have any questions, please email us at info@thetinylight.com

Thank you so much!

Child's Name

First Name

Last Name

Parent or Guardian's Name

First Name

Last Name

Date of Birth

Tiny Light DOB

YYYY

Current age of Tiny Light

Diagnosis: Please explain.

What was your reaction to the diagnosis?

When did you find out? What were your feelings? How did you tell your child?

We would like this to be as personal as possible. If you have problems answering some of the questions or they do not apply to you, just skip it and go on to the next. The remainder of the space is for you to write freely.

What you have been through is not easy. What was/has been the hardest thing throughout this journey?

What has been the most amazing thing about this journey?

What about your child inspires you?

List five of their favorite activities, or what they are good at.

If you could tell one thing to another child/family who is suffering from the same illness, what would it be?

Can you please describe what the future may hold for your child?

What are your hopes and dreams for your Tiny Light?

What are your fears? What helps you over come them?

By entering your email below, I agree that everything said in this interview is in fact true and that The Tiny Light Foundation is allowed to quote me/and or my participant with anything answered above.

Child Interview Form

Thank you so much!

The Tiny Light Foundation

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