Send Warm Wishes Intake Questionnaire

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?*

Myself—I want to receive letters written to me.Someone else—I want a friend or loved one to receive letters.

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.*

First NameLast Name
What is the recipient's date of birth?*

MonthDayYear
Date
What is the recipient's mailing address? *U.S. addresses only*

Street Address

Street Address Line 2

CityState

Zip Code
Why are you signing your loved one up for this service? Please select all that apply, or write in your own.*

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

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 NameLast Name
What is your date of birth?*

MonthDayYear
Date
What is your mailing address? *U.S. addresses only*

Street Address

Street Address Line 2

CityState

Zip Code

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.*

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.*

MaleFemaleNo preference

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.*

MaleFemaleNo preference

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.*
What is your loved one's SECOND FAVORITE hobby or interest? Again, please give specifics.*
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.

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.*
What is your SECOND FAVORITE hobby or interest? Again, please give specifics.*
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.

What is your loved one's living situation? Do they have any pets or companions? Are they independent or do they need assistance?*
Does your loved one have any professional interests? What is/was their career?*
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.

What is your living situation? Do you have any pets or companions?*
Do you have any professional interests? What is/was your career?*
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.

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 NameLast Name
How did you hear about us?*

Search engine (Google, Bing, etc.)Email (newsletter, promotional email, etc.)Social media (Facebook, Instagram, etc.)Word of mouthAnother website or blogOther

How did you hear about us?*

Search engine (Google, Bing, etc.)Email (newsletter, promotional email, etc.)Social media (Facebook, Instagram, etc.)Word of mouthAnother website or blogOther
Should be Empty:

Part 1: Recipient Contact Information