Request for testimonial | Fondation du CHUM

The CHUM Foundation loves to give a platform to patients, their loved ones and to members of hospital staff, who wish to share their experiences or speak about the CHUM’s impact on their lives.

In completing this form, you will help our team learn more about your experience. We will contact you shortly thereafter to schedule a testimonial interview.

Thank you for sharing with us!

First name(Required)

Last name(Required)

Email address(Required)

Telephone number

Relationship with the CHUM(Required)

Current or past patient

Hospital staff

Friend/family member of patient

Donor

Tell us a little bit about your story(Required)

Do you prefer to be contacted by:(Required)

Telephone