Young People SHARE

Power of Story Young People

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Young Person's Name*

FirstMiddle (if known)Last
Describe them to us.*
Personality, interests, favorites, strengths, weaknesses, relationships, nicknames, highs and lows.
What do you want to make sure they know?*
Lessons they have taught you, dreams for their future, important people, other important facts, stories or information.
Your Name*

FirstLast
Email*
example@example.com
Phone*
Would you like a follow up call?*

No, I will share everything I know belowYes, I will schedule a time that works for me after I hit submitYes, have someone call me
Click to expand each section below and share additional information. These items are optional, but so important to {youngPersons}.

Scroll down to hit submit when done.

More About Them
Their Birth and Early Years
First memories, visits in the hospital, or as a newborn, pregnancy, prenatal care, complications during pregnancy or birth.
Their Medical and Mental Health Information
Illnesses, hospitalizations, surgery's, medications, allergies, immunizations, evaluations, mental health, medical and dental providers.
Their Education
Schools and preschools attended, assessments/IEP/504, subjects excelled at or struggled in, relationships with peers.

Out-of-Home Experiences
When They Moved Into Out-of-Home Care.
What life was like BEFORE moving into care, and why they entered out of home care.
Their Experiences In Out-of-Home Care.
Relationships made, traditions, memories from caregivers, highs and lows.

Upload Photos, Artwork or Documents
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Power of Story Young People