Hope Stones Program

ORDER FORM

Please complete the following form to order your Hope Stones for your child.

Hope Stones Program Registration

Contact Information
Child's Name*
Parent / Guardian Name*
Address*
Street Address Address Line 2 City Province Postal Code
Email*
Phone*
Diagnosis*
Primary Hospital / Clinic
Primary Doctor
Hope Stones
Below is a list of Procedures and the corresponding Hope Stone.

Please fill out the number required by the Child based on the number of procedures they have undergone.
Admission to Hospital - Teddy Bear Quantity
Price: $ 0.00 CAD
Attended Camp - Tree/Camping Quantity
Price: $ 0.00 CAD
Catheter, Tubes or Drains In & Out - Gold Sphere Quantity
Price: $ 0.00 CAD
Central line or PICC line - Silver Heart Quantity
Price: $ 0.00 CAD
Clinic Visit - Marine Animal Quantity
Price: $ 0.00 CAD
Brain or Spinal Surgery - Four Leaf Clover Quantity
Price: $ 0.00 CAD
Biopsy - Tube Bead Quantity
Price: $ 0.00 CAD
Dental - Tooth Bead Quantity
Price: $ 0.00 CAD
Discharge - Happy Face Quantity
Price: $ 0.00 CAD
Dressing Change - Red Round Quantity
Price: $ 0.00 CAD
ER Visit - Farm Animal Quantity
Price: $ 0.00 CAD
EVD - Fruit Quantity
Price: $ 0.00 CAD
Glenrose Hospital - Peace Sign Quantity
Price: $ 0.00 CAD
Intubation & Extubation - Purple Star Quantity
Price: $ 0.00 CAD
Isolation - Hand Quantity
Price: $ 0.00 CAD
IV Start & Stop - Silver Star Quantity
Price: $ 0.00 CAD
Major Milestone - Angel Quantity
Price: $ 0.00 CAD
MRI, CT Scan or Ultrasound - Snowflake Quantity
Price: $ 0.00 CAD
NPO - Silver Sphere Quantity
Price: $ 0.00 CAD
Other Surgeries - Sports Quantity
Price: $ 0.00 CAD
Other Tests or Scans - Black/Silver Donut Quantity
Price: $ 0.00 CAD
Orthotics - Foot/Hand Braces & Helmets - Foot Quantity
Price: $ 0.00 CAD
Oxygen, CPAP or BiPAP - Clear Sphere Quantity
Price: $ 0.00 CAD
Physio or Occupational Therapy - Candy Quantity
Price: $ 0.00 CAD
PICU or NICU Admission - Blue Heart Quantity
Price: $ 0.00 CAD
Needle Pokes & Blood Work - Red Heart Quantity
Price: $ 0.00 CAD
Procedure Bead - Safari/Jungle Quantity
Price: $ 0.00 CAD
Satellite Visit - Moon Quantity
Price: $ 0.00 CAD
School - Music Quantity
Price: $ 0.00 CAD
Shunt Infection - Orange Donut Quantity
Price: $ 0.00 CAD
Shunt or Reservoir Tap - Birds Quantity
Price: $ 0.00 CAD
Sutures or Staples Removed - Butterfly/Lady Bug Quantity
Price: $ 0.00 CAD
TPN - Hot Pink Quantity
Price: $ 0.00 CAD
Transfusion - Flower Quantity
Price: $ 0.00 CAD
Transport of Any Kind - Transportation Quantity
Price: $ 0.00 CAD
Wound Infection - Green Sphere Quantity
Price: $ 0.00 CAD
X-ray - Gold Heart Quantity
Price: $ 0.00 CAD

The following websites are great sites for kids, tweens & teens just like you!

Bullying is a widespread and serious problem that can happen anywhere to anyone. Are you being bullied? Do you see bullying at your school? There are things you can do to keep yourself and the kids you know safe from bullying.

BULLYING

KidsHealth gives kids and families advice and comfort about a wide range of physical, emotional, and behavioral issues that affect all children and teens.

KidsHealth

A fun, interactive site that takes you through a series of steps and games to learn more about issues related to kids with special needs. Through the Web Quest you will become “virtual investigators”, searching for information by exploring not only the Internet but also your own school and neighborhood.

Kids Quest

The whole Sesame Street is great for any kid! On the Toolkits link, there is a wonderful page dedicated to helping families cope with serious illness. It is aimed at the toddler to preschool age group.

SESAME STREET

YOU CAN MAKE A DIFFERENCE!

Donate today to help make a child’s life exponentially better through the great work we are doing at the NKF.

DONATE TODAY!

Hope Stones Program

ORDER FORM