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© 2008 - 2009, Hemispherectomy Angels, Inc., a Non-Profit Corporation Disclaimer of warranties and liability | Web Design by Rachel Waters
Disclaimer of warranties and liability | Web Design by Rachel WatersPO Box 1239 | Aledo, Texas 76008 All Accounting Services Provided by Shelton, Mead, and Shelton, CPAs
All Accounting Services Provided by Shelton, Mead, and Shelton, CPAsRegister
Why registration is important for our work at the Hemispherectomy Foundation:
When people make themselves known to us we can document the incidence of hemispherectomies. The Hemi Foundation receives no US Census figures and no reports from other government sources. We rely on those who contact us to provide us with statistical data in an effort to advocate for increased services and research. Our figures are only part of the whole international data pool but each additional piece of the puzzle is valuable.
Your registration also ensures you are kept up to date on Hemi Foundation news, events and enrolls you in our Hemi Hugs program. Also available is our Family Matching program where we connect you with other hemi-families, with your permission. You will also have the opportunity to apply for scholarships, camp tuition assistance and more.
*Contact information and data on patients is kept confidential unless permission is given to share with other hemi-families.
If you would like us to post your child's picture on our website, please send to our Webmaster.
First Name:
Do you have a Website:
Date of Birth:
Mother and Father:
Email Address:
Alt. Email:
Address:
City:
State:
Country:
Phone:
Who referred you to us?
Alt. Phone:
Other Children:
Last Name:
Date of Surgery:
Hospital:
Surgeon:
Reason for Surgery:
Hemi Side:
Seizure free?:
Food Restrictions:
Would you like to connect with other hemi-families?
Other Notes:
Picture:
Zip Code:
About Your Child
Is it okay for us to give your contact info to other hemi-families?
Additional Information
