Children's of Mississippi – Family Interest Form

Thank you for your interest in the Children's of Mississippi Patient Ambassador Program. Our Patient Ambassadors are extraordinary children and families who choose to share their personal stories to bring hope, raise awareness, and inspire support for Mississippi's only children's hospital. Through their stories, they help others understand the impact of compassionate, life-changing care at Children's of Mississippi.

As an Ambassador family, you will have the opportunity to share your child's health story in a way that feels meaningful and comfortable for you. Whether big or small, every story makes a difference. Opportunities may include:

• Attending and participating in special events and fundraisers​
• Speaking at community or donor engagements​
• Sharing your story through media (TV, radio, magazines, online)​
• Creating thank-you notes, artwork, videos, or messages for donors

Additionally, ambassador families may also receive:

• A featured story in the 2027 Children's of Mississippi patient calendar
• Opportunities for additional story spotlights and publications
• Consideration to be selected as a Children's of Mississippi CMN Champion

Ambassadors must be former or current Children's of Mississippi patients between the ages of 1-17. Ambassadors must commit to serving for one year.​

We are currently accepting nominations for our 2027 patient ambassadors. A parent or legal guardian must submit this form. Nominations are due Wednesday, May 13, 2026.