Please take a few minutes to complete this one page form.
The form is seeking to particular touching or amazing stories because of your SHC. If your story is particularly touching and amazing they may be featured on the LPHI website, used for advocacy, or used to indicate to our funder how the SBHC's are helping others.
INSTRUCTIONS: Answer each question in a BRIEF (2-3 sentences) manner without revealing any identifying information for the patient or client.