Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Monroe Carell Jr.
Children's Hospital
at Vanderbilt
2200 Children's Way
Nashville, TN 37232

(615) 936-1000

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Entertainment Visitor Request Form

Name of individual or group*
Contact Person*
Day time phone*
Preferred date*
Preferred date 2
Preferred Date 3
Describe your visit
Equipment and props
Recommended ages for participation
Anticipate Media Coverage
Number of people in group
Anticipated Photographs
Patients and families may enjoy performances and activities at the bedside via closed circuit television. So that our AV team may be prepared to support your event, please indicate what type and number of instruments, CDís, tracks to be played, iPad or laptop connections, as well as needs for direct input boxes, microphones, and monitors.
As a representative of the above named organization, I have read the requirements for special group visits to Childrenís Hospital and affirm my groupís willingness to adhere to these guidelines. I understand Entertainment Visitor Request Forms are reviewed on a monthly basis and I will be contacted regarding my request within 4 weeks of receipt. I also understand that a completed Visitor Entertainment Request Form does not guarantee an approved volunteer event. Please Note: Upon approval of your request, further orientation and information about visiting Childrenís Hospital will be provided for you and your volunteers.

By checking this box, you are agreeing to the statement above.
Date of signature
*required field

Valued Participant of Vanderbilt Health Affiliated Network