Share Your Miracle Story

Dr. Nathan RoeslerChildren’s Miracle Network Hospitals in Southeast Texas welcomes families to share what they experienced* while their child (0-18 years old) was treated at one of our hospitals. Each child who comes through our doors benefits from resources funded by local donations to Children’s Miracle Network Hospitals. Personal stories from these families help us show our community the direct impact their donations have on children in Southeast Texas.

If your child was a patient or was born at CHRISTUS Southeast Texas St. Elizabeth or Jasper Memorial Hospital, we invite you to share your “Miracle Story.” Whether your child suffered from a broken bone, the flu, or another illness or injury, we want to hear about your experience. If you are interested in helping us show our donors the difference their dollar makes, please share your experience by filling out the form below and uploading a signed copy of the consent form.

*Please note that this form is not intended for adult patient experiences and is not the proper channel for filing a complaint or concern. Any complaints or concerns submitted here will not be resolved. CHRISTUS Southeast Texas’ guest services and patient advocate programs are designed to assist patients and family members by providing a structured approach to resolving complaints, forwarding suggestions and routing compliments. Visit their website for more information.

 

  • Guardian Information

  • Pediatric Patient Information

    Pediatric patients are ages 0 to 18 at the time they are seen or admitted.
  • Miracle Story

  • Approximate date child was seen or admitted.
  • Approximate date child was discharged.
  • Your experience may be as detailed or as general as you want. Here are some questions to help you tell your story: How did you and the patient feel before, during, and after your stay? Who were the clinical staff members who helped you? What kind of medical care did the patient receive? What resources were you particularly thankful for during your visit? How is the patient doing now?
  • We love to have a face with the name! You may also upload any images that complement your Miracle Story. You may include photos of the patient in the hospital, with clinical staff members, or even just having fun after his or her hospital visit.
    Drop files here or
  • Upload your signed consent form to give us permission to use your story. Download a copy of the form using the link above or at: https://www.christussoutheasttexasfoundation.org/wp-content/uploads/2018/01/Photo-Release-Consent-Form.pdf
  • Nothing is more impactful or compelling than hearing someone share their personal experience firsthand. Please check any opportunities where you would be willing to share your Miracle Story.