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Dream Questionnaire
Please take a moment to tell us about your dream experience. We appreciate your feedback!
Your name
(Required)
First
Last
Child's name
(Required)
First
Last
Child's age
(Required)
Child's diagnosis
(Required)
What was your child's favorite thing about the dream?
How has having this dream come true affected your child?
Do you feel that having this dream come true improved your child's health in any way?
(Required)
Yes
Somewhat
No
In what area did you notice the most improvement in your child during this experience?
(Required)
Check all that apply
Emotionally (happier, calmer, peaceful, upbeat, stable)
Interactive (talked more, more outgoing, open to trying new things)
Expressions (laughing, smiling, singing)
During this trip, did your child's pain or discomfort from their illness seem to...
(Required)
Decrease
Stay the same
Increase
How did this experience affect you and/or your family?
(Required)
Did your child's dream include staying at the Dream Village
(Required)
Yes
No
What was your arrival date?
(Required)
MM slash DD slash YYYY
Which park(s) did you visit?
Check all that apply
Disney World
Universal Studios
LEGOLAND
Sea World
Discovery Cove
What was your child's favorite thing about the Dream Village?
Share your photos
Please upload your favorite photos from the trip! Note: if sharing more than 5 photos or have large image sizes, please email them to
*protected email*
Drop files here or
Select files
Max. file size: 512 MB, Max. files: 5.
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