Hope the Lion Plushies Request Form:
Hope reminds everyone that where there is a person living with epilepsy, there is Hope. Lions represent courage, strength and pride. Hope the Lion is free for people living with epilepsy in MA, NH, ME & RI.
Does Recipient Have Epilepsy
Do you live in MA, NH, ME or RI
Who is the recipient of Hope the Lion?
Please know that if you live out of our service area (Massachusetts, New Hampshire, Maine or Rhode Island) or you have requested a plushy for someone who does not have epilepsy there will be a $35 cost for a Hope the Lion package. https://www.classy.org/event/hope-the-lion/e268982
Hope Lion Recipients Name
Date of Birth
Street Address Line 2
State / Province
Postal / Zip Code
Hospital Affiliated with
If requesting Hope for your child or other please tell us your Name.
What is your relationship to the recipient of Hope the Lion
How did you hear about Hope?
Health Care Provider
Teacher or Educator
Epilepsy Foundation New England
Any additional information you would like to give us:
Should be Empty: