Send Warm Wishes Intake Questionnaire
This form should take around 10-15 minutes to complete.
Who are you signing up for our service, yourself or someone else?
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Myself—I want to receive letters written to me.
Someone else—I want a friend or loved one to receive letters.
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Part 1: Recipient Contact Information
Enter your loved one's contact info. This is for the person who will be receiving the letters. Note: Our letter service is one-way, meaning your loved one will not be asked to respond.
Please enter the letter recipient's full name.
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First Name
Last Name
What is the recipient's date of birth?
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Month
-
Day
Year
Date
What is the recipient's mailing address? *U.S. addresses only
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Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Why are you signing your loved one up for this service? Please select all that apply, or write in your own.
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I feel my loved one is lacking connection, and I want to support their emotional well being.
I know my loved one enjoys receiving mail, but I worry about them being exploited. I like that this service is one-way to protect their privacy.
I live far from my loved one and don't have as much time as I'd like to connect with them—in person, by mail, or otherwise.
Other
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Part 1: Recipient Contact Information
Enter your contact info. Note: Our letter service is one-way, meaning you will not be asked to respond to the letters you receive.
Please enter your full name.
*
First Name
Last Name
What is your date of birth?
*
-
Month
-
Day
Year
Date
What is your mailing address? *U.S. addresses only
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Part 2: Recipient Interests & Preferences
This is your chance to tell us about your loved one. The more info we have, the easier it will be to create a highly personalized experience.
How does your loved one like to spend their free time? Please choose the option that most closely reflects your loved one's day-to-day life. If none apply, write in your own.
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Consuming media: Watching TV or movies, reading books or articles, listening to music or podcasts, etc.
Socializing: Spending time with family or friends, engaging in group activities, telling stories, playing games, etc.
Staying active: Going on walks, stretching, spending time outdoors, etc.
Engaging in spiritual or faith-based activities: Attending or watching religious services, engaging in prayer, reading or reciting scripture, meditating, etc.
Tapping into their creative side: Knitting, crocheting, journaling, doing arts and crafts, etc.
Other
Would your loved one prefer receiving letters written from a male or female voice? If you select "no preference," our team will use our best judgment to match your loved one with one of our Wishers.
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Male
Female
No preference
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Part 2: Recipient Interests & Preferences
This is your chance to tell us about yourself. The more info we have, the easier it will be to create a highly personalized experience.
How do you like to spend your free time? Please choose the option that most closely reflects your day-to-day life. If none apply, write in your own.
*
Consuming media: Watching TV or movies, reading books or articles, listening to music or podcasts, etc.
Socializing: Spending time with family or friends, engaging in group activities, telling stories, playing games, etc.
Staying active: Going on walks, stretching, spending time outdoors, etc.
Engaging in spiritual or faith-based activities: Attending or watching religious services, engaging in prayer, reading or reciting scripture, meditating, etc.
Tapping into my creative side: Knitting, crocheting, journaling, doing arts and crafts, etc.
Other
Would you prefer receiving letters written from a male or female voice? If you select "no preference," our team will use our best judgment to match you with one of our Wishers.
*
Male
Female
No preference
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What is your loved one’s FAVORITE hobby or interest? Please give specifics. For example, if their top interest is sports, tell us which sports or teams they enjoy playing or watching.
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What is your loved one's SECOND FAVORITE hobby or interest? Again, please give specifics.
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What is your loved one's THIRD FAVORITE hobby or interest? This question is optional. Feel free to skip if your loved one does not have additional interests.
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What is your FAVORITE hobby or interest? Please give specifics.For example, if your top interest is sports, tell us which sports or teams you enjoy playing or watching.
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What is your SECOND FAVORITE hobby or interest? Again, please give specifics.
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What is your THIRD FAVORITE hobby or interest? This question is optional. Feel free to skip if you do not have additional interests you want to share.
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What is your loved one's living situation? Do they have any pets or companions? Are they independent or do they need assistance?
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Does your loved one have any professional interests? What is/was their career?
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Our letters do not touch on politics or religion. Are there any other subjects we should avoid when writing to your loved one? If not, feel free to skip this question.
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What is your living situation? Do you have any pets or companions?
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Do you have any professional interests? What is/was your career?
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Our letters do not touch on politics or religion. Are there any other subjects we should avoid when writing to you? If not, feel free to skip this question.
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Part 3: Purchaser Contact Information
That's you! We will match this information with your order to ensure your loved one receives the correct number of letters.
What is your full name?
*
First Name
Last Name
How did you hear about us?
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Search engine (Google, Bing, etc.)
Email (newsletter, promotional email, etc.)
Social media (Facebook, Instagram, etc.)
Word of mouth
Another website or blog
Other
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How did you hear about us?
*
Search engine (Google, Bing, etc.)
Email (newsletter, promotional email, etc.)
Social media (Facebook, Instagram, etc.)
Word of mouth
Another website or blog
Other
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