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Phone:

801-877-2852

Mailing Address:

United Angels Foundation

1411 W. 1250 S. Suite 310

Orem, Utah 84058

Email:

info@unitedangels.org

Complete This Form To Join United Angels

First Name *

Last Name *

Email *

Relationship To Child:

Parent

Friend of Family

Other Relative

Legal Guardian

I hereby grant explicit permission for United Angels to communicate with me. This permission includes, but is not limited to: permission to call, text, leave ringless voicemails or voicemails, voice broadcasts, carrier pigeons, morse code messages, or any other way to let you know what's going on with United Angels (which is hopefully why you are joining). United Angels acknowledges that you can revoke this permission in writing also.

Tell Us About Your Angel

Child First Name *

Child Last Name *

Select your Angel's primary condition in the dropdown below:

Angel's Primary Condition *

Angel's Primary Condition

Asperger Syndrome
Autism
Cerebral Palsy
Down Syndrome
Multiple Sclerosis
Muscular Dystrophy
Spina Bifida
Unknown Diagnosis
Other
No elements found. Consider changing the search query.
List is empty.

Select your Angel's secondary condition in the dropdown below (optional):

Angel's Secondary Condition

Angel's Secondary Condition

Asperger Syndrome
Autism
Cerebral Palsy
Down Syndrome
Multiple Sclerosis
Muscular Dystrophy
Spina Bifida
Unknown Diagnosis
Other
No elements found. Consider changing the search query.
List is empty.

Tell Us About Your Angel

Do you have a second child with special needs?

Yes

No

Tell Us About Your Angel

Second Child's First Name

Second Child's Last Name

2nd Angel's Primary Condition

Choose one...

Asperger Syndrome
Autism
Cerebral Palsy
Down Syndrome
Multiple Sclerosis
Muscular Dystrophy
Spina Bifida
Unknown Diagnosis
Other
No elements found. Consider changing the search query.
List is empty.

2nd Angel's Secondary Condition (optional)

Choose one...

Asperger Syndrome
Autism
Cerebral Palsy
Down Syndrome
Multiple Sclerosis
Muscular Dystrophy
Spina Bifida
Unknown Diagnosis
Other
No elements found. Consider changing the search query.
List is empty.

Tell Us About Your Angel

Do you have a third child with special needs?

Yes

No

Tell Us About Your Angel

Child 3 First Name

Child #3 First Name

3rd Angel's Primary Condition

Choose one

Asperger Syndrome
Autism
Cerebral Palsy
Down Syndrome
Multiple Sclerosis
Muscular Dystrophy
Spina Bifida
Unknown Diagnosis
Other
No elements found. Consider changing the search query.
List is empty.

3rd Angel's Secondary Condition (optional)

Choose one

Asperger Syndrome
Autism
Cerebral Palsy
Down Syndrome
Multiple Sclerosis
Muscular Dystrophy
Spina Bifida
Unknown Diagnosis
Other
No elements found. Consider changing the search query.
List is empty.

Contact Information

Phone *

Address *

City *

State *

Postal code *

Meeting Preferences

Would you like to have a visit or call by a member of the United Angels Foundation? *

Choose One

I'd like an in-person visit
I'd like a call
I don't want to be contacted for an initial visit or call
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Meeting Preferences

Where would you prefer to meet?

Choose one...

United Angels Office (Orem, UT)
My Home
Hospital
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Preferred Meeting Time

Morning

Afternoon

Evening

Preferred Days of Week for Meeting

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

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