Presbyterian Hemby Children’s Hospital Donation, Service Project & Visitation Guidelines Thank you for your interest in supporting Presbyterian Hemby Children’s Hospital! Children and families are removed from their normal environments and are thrown into a world of chaos and stress during a child’s illness and hospitalization. Our goal is to help patients and their families cope with hospitalization by providing support and normalization within the hospital environment. One way to do this is through group visits and donations. All donation items and goodie bags will be shared between pediatric areas of the hospital unless otherwise specified, to include the pediatric floor, pediatric intensive care unit (PICU), neonatal intensive care unit (NICU) and children’s emergency department. We appreciate your willingness to participate in our efforts to support our families. For the health and safety of our patients and families we have certain guidelines for donations, service projects and group visitation. Please read through the below guidelines for donations and visitation. If you are able to meet the requirements, please contact the child life department to schedule a donation drop off or fill out the attached visitation form to schedule a visit to Hemby Children’s Hospital. Service Project & Group Visitation Policy We are delighted to have groups come visit pediatric patients in the hospital. All group visits and service projects must be scheduled with the child life department prior to visitation. We allow a maximum of two groups per day at 11 a.m., 2 p.m. or 6 p.m. Our event calendar is made at least a month in advance so all visitation requests must be made at least one month ahead of time. There is a limit of six people per group visit and the minimum age requirement for visitation is 14 years old. Suggested group projects and service projects include: arts & crafts activities, off‐site event to raise money for hospital needs, sponsor dinner for inpatient families (food must be commercially bought and prepared) or host hospital movie night. All group and service projects must be approved and scheduled by the child life department. All special guests will be asked to sign a confidentiality agreement with Presbyterian Hemby Children’s Hospital. Unfortunately, not all requests can be honored due to patient interest and/or time constraints. Elizabeth Gray
Child Life Supervisor
Presbyterian Hemby Children’s Hospital
704.384.5134
[email protected]
Presbyterian Hemby Children’s Hospital Donation, Service Project & Visitation Guidelines Donations to the Child Life Department General Donations & Goodie Bag Requirements: ‐Must be new and un‐used ‐Packaged in new and clean bags or containers ‐Store bought: not stored in attics, basements or garages ‐Be kept or prepared in pet and smoke‐free environments ‐Avoid themes that imply violence or religion ‐Non‐violent; PG‐13 and under in rating ‐Avoid items that could be choking hazards (could fit in a film canister). ‐No glitter, glue or food items ‐Latex‐free items Suggested Items for Donations: ‐Brave Basket Items ‐$1 ‐$5 prizes ‐$5 gift cards (i‐Tunes, Starbucks, Target, Wal‐Mart, Best Buy) ‐Portable DVD players ‐DVDs (G, PG & PG‐13) ‐ please pick current movies and new releases ‐Crayons/markers: 4, 8 and 10 packs ‐Noisy and light‐up toys and books ‐Board games, UNO and playing cards (toddler‐adolescent) ‐Sodoku, crossword puzzles, word searches ‐Coloring books, activity books and stickers ‐Barbie and baby dolls of all ethnic backgrounds ‐Cars, trucks, motorcycles (toddler – adolescent) ‐Themed toys: SpongeBob, Dora & Diego, Spiderman, superheroes, Thomas the Train and Disney princesses ‐Bus passes and phone cards ‐Pajama bottoms, underwear, onesies and socks (all sizes) ‐Board books ‐Teethers & rattles Elizabeth Gray
Child Life Supervisor
Presbyterian Hemby Children’s Hospital
704.384.5134
[email protected]
Presbyterian Hemby Children’s Hospital Donation, Service Project & Visitation Guidelines Entertainment/Group Visit Request Form We appreciate your interest in visiting the children at Presbyterian Hemby Children’s Hospital. Please complete the following form and leave the shaded areas blank as these will be completed by the child life staff. We will do our best to accommodate your scheduling desires. Please submit this request form at least one month prior to your first choice scheduling date. Name of Group: Address: Name of Contact: Phone Number: Email Address: Describe in detail what activity/event you would like to provide (request will be returned without detailed information): ________________________ _____ Recommended patient age for participation: Number of people in group (no more than 6 total): Adults: Children (must be 14 years or older): Anticipated media coverage: Yes No Approved by: _________________ Anticipated Photographs: Yes No Approved by: Preferred date: 1st date: ____________2nd date: ____________3rd date: Please list in detail the craft items, gifts, and/or handouts that you would like to bring: ________ _________________________________________________________________ Signature:__________________________________________________________ Please sign and return with the: Entertainment/Group Visit Information Sheet that is listed below. Elizabeth Gray
Child Life Supervisor
Presbyterian Hemby Children’s Hospital
704.384.5134
[email protected]
Presbyterian Hemby Children’s Hospital Donation, Service Project & Visitation Guidelines Entertainment/Group Visit Information Sheet As a representative of I affirm that the group has read the requirements for groups and entertainers visiting Presbyterian Hemby Children’s Hospital and affirm the group’s willingness to adhere to these guidelines.  We understand that the group must arrive at the Hemby lobby (2nd floor beside the birdcage) at 1:30 p.m. on the day of the visit.  We understand that if the group is more than 20 minutes late without notifying the number listed, our visit will be canceled.  We understand that the group must dress appropriately: casual business attire, no denim or open toed shoes (flip flops, sandals, etc).  We understand that no one under the age of 14 will be allowed on the patient floors.  We understand that no member of the group with a scratchy throat, cold or fever will be allowed to interact with the patients.  We understand that all items to be given to the children must be cleared through the child life specialists and all items must be new.  We understand that the group cannot distribute religious materials or messages.  We understand that no photographs of the patients can be taken without written permission from the family.  We understand that a patient’s privacy is of utmost concern and all visitors will be asked to sign a confidentiality agreement  We understand that no more than six people will be allowed to visit the patient floors. Contact Name (Print): Signature: Date: Please return to: Hemby Children’s Hospital Elizabeth Gray‐ Child Life Supervisor 200 Hawthorne Lane ‐2B Charlotte NC 28204 Or [email protected] (this allows for faster processing) Approved By: Elizabeth Gray
Child Life Supervisor
Presbyterian Hemby Children’s Hospital
704.384.5134
[email protected]