Family Story Form
Month/Year you stayed at Hospitality House
What best describes you during your time with Hospitality House?
I stayed at Hospitality House
I was the Primary Caregiver of my patient
I was a patient receiving care
Miles from home
Relationship of loved one receiving inpatient/outpatient care
How many days have they been hospitalized?
What type of treatment are they receiving?
My biggest worry is...
Hospitality House has provided me with...
Without Hospitality House, I would have spent $_______ on lodging/meals
Without Hospitality House, I would have spent ____ nights sleeping in a waiting room/hospital chair
Because of the kindness of strangers (Hospitality House donors, volunteers, etc.), I have been able to..
What would you say to encourage other families facing a medical crisis?
What does "Hospitality" mean to me...
Should be Empty: