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Contact Information

Please Note: At this time, Beyond The Cry Foundation is able to provide tangible resources, including care packages and adaptive equipment, to families residing within the United States.

For adaptive equipment, priority is given to local pickup in Valdosta, Georgia. Families requesting shipping are welcome to apply; however, recipients are responsible for shipping cost. As our funding grows, our hope is to expand these services to families around the world.

Parent/Guardian Name*

Email*

Phone*

City/State*

Are you able to pick up in Valdosta, GA?*

Yes

No, I need shipping

Child's Age*

Child's Diagnosis*

Briefly describe your child's equipment needs.*

Equipment requesting?*

Leckey Mygo Stander

Electric HiLo Comb Safe Sleep Bed

Bantam Stander

Rifton Pacer Size Medium

Rifton Wave Bath Chair

Medline Hoyer

Zing Easy Stand

I understand this equipment is donated as-is and may not be a perfect fit for every child.

I understsand I am responsible for shipping costs if I am selected (if not local pick up).

I acknowledge that completing this application does not guarantee I will recieve equipment.

Would you be open to sharing your child's story?*

yes

Contact

First name

Last name

Message

NICU Care Package Application

This application helps us understand how we can best support your family during your NICU journey. Our NICU care packages are designed to provide comfort, encouragement, and practical support during a difficult season. All information is kept confidentail and reviewed with care.

First name*

Last name*

Email address*

Phone number*

Full Shipping Address*

Baby's Date of Birth*

Current NICU Hospital (Name & City)*

Has your child been diagnosed with Cri du Chat Syndrome>*

Yes

Please share a little about your baby and your NICU journey. *

I confirm the information provided is accurate and understand care packages are based on availability and funding.

Request Supplies

This forms allows families to request essential supplies during their transition home from the NICU. Requests are confidential and reviewed with care. Due to limited resources, supply distribution is based on availability and family need.

First name*

Last name*

Phone number*

Email*

Full Shipping Address*

Child Name, Age, Date of Birth*

Has your child been diagnosed with Cri du Chat Syndrome?

May we share your story or photos to help raise awareness for Cri du Chat Syndrome?*

Yes

I confirm the information provided is accurate and understand supply support is based on availability.

Beyond The Cry Foundation Inc.

Faith | Family | Fight

beyondthecry@gmail.com