Our mission is to bring joy to children with significant health or life altering conditions and relief to their families by creating happier and more functional living spaces.
Welcome Home Angel serves families with children who have chronic conditions, physically debilitating injuries, or significant developmental disabilities who are restricted by limitations in the following areas of major life activity: self-care, mobility, or capacity for independent living. We serve children ages 4-21 in the Wilmington region (New Hanover, Pender, and Brunswick Counties). We now also serve children in the Charlotte Metro area!
We renovate the child's bedroom (and sometimes other living spaces, depending upon need). Many renovations are primarily aesthetic to enrich the environment where the child spends so much time and calls their own, but other renovations are major, to include door widening, handicap accessible bathrooms, and ramps. We also do a makeover of any siblings' bedrooms so they don’t feel left out.
We respect the privacy and confidentiality of all information that we receive about each family, whether we accept their case or not.
This application is the first step you must take for your child to be considered for Welcome Home Angel’s services. Once your application is received, we will contact you soon with more information.
The services that Welcome Home Angel provides to you and your family are completely free of charge!
Your Child's Name
Date of Birth
Who is your child's primary healthcare provider (doctor's name and practice)?
Please provide a phone number for your child's primary healthcare provider.
Who is best to consult with us about the child's condition and its effect on daily life in the home? (e.g. Social Worker, Physical Therapist, Home Health Nurse, CAP-C Case Manager, etc.)?
Please provide a phone number for the above-named person.
Do we have your permission to call medical providers to speak with them about your child’s condition? Note: you may be required to file medical release paperwork with your provider prior to WHA being able to discuss your child’s condition.
Please give us your child's condition/diagnosis.
What was the date of your child's diagnosis?
Does your child require a wheelchair?
Does your child require an oxygen tank?
Does your child require a Gastrostomy Tube?
Does your child require a catheter?
If there are additional health considerations we should take into account, such as allergies, please explain them.
Are you this child's...
Biological ParentLegal GuardianNeither
Best Phone Number to Reach You
Preferred Method of Communication
Do you live with the child on a full-time basis? If not on a full-time basis, we will request custody agreements and/or proof of custody.
How many siblings are living in the home?
Do others live in the home who are not siblings or guardians?
Is your home owned or rented?
If your home is owned, is it owned by you?
If your home is rented, would you be willing to commit to a long-term lease in your current home?
YesNoDo Not Rent
Do you own the furniture in your home?
Please describe a day in the life of your child in your current home, as it is. What are his or her daily challenges? What works well? What are your family’s challenges in the home in caring for the child?
Describe what you feel are the most important changes that need to be made in your child’s bedroom to better accommodate limitations and challenges your child faces due to his/her condition. If you would like us to consider other areas of the home, please describe challenges in those areas, as well.
Explain any particular aesthetic preferences for the child’s room (likes/dislikes, colors, styles, etc.) Note: We design with the future in mind, because the child’s aesthetic preferences will change as he/she grows, and our goal is to design your child’s room for today and 10 years from now - not all current decor wishes are always feasible.
Welcome Home Angel is hiring again! Please...