Give a Hippo. Share a Smile

Do you know someone who’s fighting a life-threatening illness or at the end stages of life?

Let’s lift their spirits by sending them a Healing Hippo. Please complete the form below to have a Healing Hippo, “Buttercup” sent to them.

Who can arrange for a Healing Hippo?

If you are family, friend, medical personnel or social worker, you can arrange to have a Healing Hippo mailed out.

Eligibility:

To be eligible to receive a Healing Hippo you must meet the following criteria:

The recipient has a life-threatening medical condition.
The recipient has not already received a Healing Hippo.
Completion of the Healing with Smiles submission form.

Privacy Policy:

Healing with Smiles respects the privacy of our Healing Hippo recipients, and their friends and family. All Medical and personal information is kept confidential.

Recipient's Information

First Name

Last Name

Address

Country

Province/State

City

Postal/Zip Code

Phone Number

Age of Recipient

0-5

6-13

14-29

30-49

50+

Requestor's Information

First Name

Last Name

Country

Why do you think the recipient will benefit from receiving a Healing Hippo?

Note: One (1) hippo per request/recipient.