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Menu
  • Home
  • About Us
    • Mission and Values
    • Our History
    • Parenting Resources
    • Accreditations  & Awards
    • Leadership
    • Join Our Team
    • Annual Report
    • Financials
    • Contact
  • Care & Services
  • Our Providers
  • Activities
    • Community
    • Events
    • Recreation
    • View Calendar
    • Adopt-A-Family
  • Ways to Give
    • Donate
    • Become a Monthly Patron
    • Adopt-A-Family
    • AZ Charitable Tax Credit
    • Volunteer
    • Sponsorships
    • 2023 El Tour de Tucson Team
    • Millions for Tucson Raffle
    • Resources

Family Large Adopt-A-Family Application

  1. Home
  2. Family Large Adopt-A-Family Application

    Family (Large) Application for Adopt-A-Family

    It is important that all sections are completely and appropriately filled out. Submitting an application does not guarantee selection for the Adopt-A-Family program. All applications will be reviewed. If you are selected, you will be contacted by the clinic to further discuss your family’s wish list. You MUST return calls or emails in a timely manner. Once you have successfully submitted your application, it will be queued for processing. Applications may take 3-4 weeks before notification.

    Is your child a patient at Children's Clinics?(Required)
    Child's Name (Patient)(Required)
    Parent/Guardian's Name(Required)
    Address(Required)
    Preferred method of contact(Required)
    Best time to contact me(Required)
    Preferred Language(Required)
    Priority is given to families that have experienced severe hardship in recent months. This field is REQUIRED.
    Main method of transportation(Required)

    Child #1

    Child's Name(Required)
    Sex(Required)
    Does this child need baby care items?(Required)
    Does this child need adaptive clothing?(Required)
    For example, she doesn’t like pink or ruffles, but likes blue and sparkly clothing. Or my child prefers gender neutral clothing.
    Interests #1
    Interests #2
    Interests #3
    Interests #4

    Child #2

    Child's Name(Required)
    Sex(Required)
    Does this child need baby care items?(Required)
    Does this child need adaptive clothing?(Required)
    For example, she doesn’t like pink or ruffles, but likes blue and sparkly clothing. Or my child prefers gender neutral clothing.
    Interests #1
    Interests #2
    Interests #3
    Interests #4

    Child #3

    Child's Name(Required)
    Sex(Required)
    Does this child need baby care items?(Required)
    Does this child need adaptive clothing?(Required)
    For example, she doesn’t like pink or ruffles, but likes blue and sparkly clothing. Or my child prefers gender neutral clothing.
    Interests #1
    Interests #2
    Interests #3
    Interests #4

    Child #4

    Child's Name(Required)
    Sex(Required)
    Does this child need baby care items?(Required)
    Does this child need adaptive clothing?(Required)
    For example, she doesn’t like pink or ruffles, but likes blue and sparkly clothing. Or my child prefers gender neutral clothing.
    Interests #1
    Interests #2
    Interests #3
    Interests #4

    Child #5

    Child's Name(Required)
    Sex(Required)
    Does this child need baby care items?(Required)
    Does this child need adaptive clothing?(Required)
    For example, she doesn’t like pink or ruffles, but likes blue and sparkly clothing. Or my child prefers gender neutral clothing.
    Interests #1
    Interests #2
    Interests #3
    Interests #4

    Child #6

    Do you have a sixth child?
    Child's Name(Required)
    Sex(Required)
    Does this child need baby care items?(Required)
    Does this child need adaptive clothing?(Required)
    For example, she doesn’t like pink or ruffles, but likes blue and sparkly clothing. Or my child prefers gender neutral clothing.
    Interests #1
    Interests #2
    Interests #3
    Interests #4

    Consent

    Photo Consent(Required)
    Do you consent to Children’s Clinics use of you or your children’s image for the Adopt-A-Family promotional purposes and other marketing materials for the clinic?
    I acknowledge that items are not guaranteed. I understand the final decision is left to the sponsor(s) who donate.(Required)
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    Children’s Clinics

    • Square & Compass Building
    • 2600 North Wyatt Drive
    • Tucson, AZ 85712

    Phone: 520-324-5437
    Toll Free: 1-800-231-8261
    Fax: 520-324-3128
    E-mail: info@childrensclinics.org

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