NICU Story Feature
Your story will be used for the purpose of sharing different NICU stories as encouragement to others. These stories will be featured on any or all social media platforms associated with Aryana Guest and possibly others.
Parents Names (Must be the legal parent/guardian of the child)
Parent 1
*
First Name
Last Name
Parent 2 (Optional)
First Name
Last Name
Are you comfortable with us sharing your name on social media?
*
Please Select
Yes
No
Your Childs Name?
Are you comfortable with us sharing your childs name on social media?
*
Please Select
Yes
No
Email
*
example@example.com
How many weeks was your baby when they were born?
*
How much did they weigh?
*
What challenges did they face or overcome?
*
Ex...lung disease, jaundice, PDA, Sepsis...etc
Is anything else you would like us to share about your birth story!?
*
Please note we will not post any hospitals or the names of any doctors or nurses.
What is your Instagram?
Would you like us to tag you in our post?
*
Please Select
Yes
No
Share any pictures or short video clips we can use for our NICU spotlight post!
*
Browse Files
Drag and drop files here
Choose a file
No more than 10 items to be uploaded please!
Cancel
of
Agreement/Understanding
You understand that you are submitting this completely voluntarily. Anything you share could be posted on all social media platforms associated with Aryana Guest, McNeal Video and Portraits, and possibly other social media platforms/accounts. If you agree to these terms please sign below.
*
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