Tell Us Your Story

Do you have a loved one who was served by Lower Cape Fear Hospice & LifeCareCenter? Would you like share a photo and tell us about that special person?

By putting a face to a hospice patient, you help others understand hospice care and allow other patients and families to benefit from our services.

Faces of Hospice:

Frederick W. Lauster Jr.

Mr. Roscoe Jacobs, Sr.

Tell Us YOUR Story

If you would like to participate in our Tell Us Your Story program, please complete the information below.

Tell Us Your Story

Do you have a loved one who was served by Lower Cape Fear Hospice & LifeCareCenter? Would you like share a photo and tell us about that special person?

By putting a face to a hospice patient, you help others understand hospice care and allow other patients and families to benefit from our services.

Faces of Hospice:

Frederick W. Lauster Jr.

Mr. Roscoe Jacobs, Sr.

Tell Us YOUR Story

If you would like to participate in our Tell Us Your Story program, please complete the information below.

* = required

*Your Name:	This is a required field
*Your E-mail Address:	This is a required field
Your Contact Phone Number:
Hospice Patient Name:
Relationship to Hospice Patient:
Hospice Patient Story (in eight sentences or less, describe your loved one, any significant information about his/her life, and what made this individual a special person):

I hereby assign to Lower Cape Fear Hospice & LifeCareCenter all rights to the attached photographs of

I further give my permission for this photograph with the patient’s name in connection therewith, to be released for public viewing through Lower Cape Fear Hospice & LifeCareCenter and public mass media mechanism(s) checked below:

Website	NewsLetter	Publication	Other:
All of the above

I further authorize the reproduction, copyright, exhibit, broadcast, and/or distribution of the same without limitation for any lawful purpose including advertising, trade, display, exhibit, website, and art and also to use the patient’s name in connection therewith.

Click on the "Browse" button below to select a file on your computer. After you've selected the file, click the "Send File" to transfer your file to us.

Photo: