Child's Case Upload for Helpster

Use this form to send information regarding children's cases suitable for the Helpster Program

Use this form to send information regarding children's cases suitable for the Helpster Program

Country *

Volunteer's name *

Child's First Name *

Child's Last name *

Child's Age *

Hospital (if known)

Where the child lives?

Health Issue *

Child's story *

Parents and their contacts *

Cost of treatment (if known)

Volunteer's Comment

Is it an Urgent case?

Parents signed both consents

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