Apply to be a Patient Ambassador | UCSF Benioff Children's Hospitals Foundation

UCSF Benioff Children's Hospitals select Patient Ambassadors each year to help build community awareness and raise critical funds for our patients and their families.

Patient Ambassador Form

Child's Name:

Child's Birthdate:

Parent or Guardian Name(s):

City of Residence:

Email:

Phone Number:

What brought you to UCSF Benioff Children's Hospitals?

Are there any physicians or staff members that hold a special place in your heart and if so, why?

Please include name, title, and department, if known.

What does UCSF Benioff Children’s Hospitals mean to you and your family?

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Please email us if you have any questions.