Wish Survey

Your feedback matters! At Indiana Wish, we are committed to ensuring every child receives the most magical and meaningful Wish experience possible. By sharing your thoughts, you help us improve and continue granting life-changing wishes to children who deserve them most.

Please take a few moments to complete our survey. Your input will guide us in creating unforgettable moments for Wish kids and their families. Thank you for being an essential part of our mission!

Wish Child Name *

First

Last

Wish Child's Wish *

Date of Wish *

Name of Person Completing the Form *

First

Last

Relationship to Child *

Can we call you if we have any questions? *

• Yes
• No

If yes, what is a good phone number to reach you?

If yes, what is a good email?

Please Rate Your Experience

How would you the the overall referral process? *

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

How would you rate the pre-wish call? *

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After the pre-wish call, did you have a clear understanding of the wish process? *

• Yes
• No

If NO, please explain why

How would you rate the communication from Indiana Wish? *

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How would you rate the friendliness of the staff? *

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

How would you rate the wish delivery process? *

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

How would you rate the timeline of having the wish granted? *

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How could we improve the overall wish experience? *

Following Questions for those who received a Wish Trip

Was your wish trip thoroughly explained, and all questions answered?

• Yes
• No

If NO, please explain why (copy)

How would you ate your travel experience arrangements?

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

How would you rate your lodging?

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

Share your Wish!

What was your child's favorite part of their wish? *

What was the wish child's parents' favorite part of the wish? *

Upload up to 5 of your favorite photos from the wish!

Click or drag files to this area to upload. You can upload up to 5 files.

Each Pictures can only be a Max of 300 KB

File Add a favorite video of yours from the wish!

Click or drag a file to this area to upload.

If submitting photo and video, please agree to the following statement: For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby grant INDIANA WISH permission to use my likeness and that of my WISH CHILD in a photograph in any and all of its publications, including but not limited to all of INDIANA WISH's printed and digital publications. I understand and agree that any photography or videography using my likeness will become the property of INDIANA WISH and will not be returned. I acknowledge that since my participation with INDIANA WISH is voluntary, I will receive no financial compensation. I hereby irrevocably authorize INDIANA WISH to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing INDIANA WIS H's programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising out of, or related to, the use of the photograph(s) or video(s). I hereby hold harmless and release and forever discharge INDIANA WISH from all claims, demands, and causes of action which I, by heirs, representative, executors, administrators, or any other person's action on my behalf of my estate have or may have reason of authorization. I am at least 18 years old and am competent. I have read this release before accepting below and fully understand the contents, meaning and impact of this release.

• Yes, I agree

Any Additional Comments?

Submit