LANTERN Interest Form

LANTERN supports families of children with serious, life-limiting illnesses, complex medical conditions and other disabilities. Share a little about your family and a member of the PPCC team will be in touch soon. All fields are required unless marked optional.

Contact information

Your sign-in link goes to this address, so we ask for it twice.

Your child or children (optional)

If you share each child's name and date of birth now, their Firefly profile will already be started when PPCC Staff set up your account. You never have to type it twice.

Only PPCC's LANTERN team sees what you share here. If you don't end up joining, we delete your submission within about a month. Privacy Policy