Nominate Someone for Wellness Support

Sometimes the most powerful thing we can do is lift someone up.

You know someone who’s struggling. Maybe they’re facing health challenges that feel overwhelming. Maybe stress and exhaustion have become their new normal. Maybe they’re so busy caring for others that they’ve forgotten to care for themselves.

This is your chance to show them they’re not alone.

Ready to Make a Nomination?

Take a few moments to share their story with us. We read every nomination with care and deep respect for what you’re sharing. There’s no “perfect” way to fill this out—just speak from the heart about why this person matters and why now is the time they need support.

A few things to know:

• Nominations are reviewed monthly

• Recipients are selected based on genuine need and willingness to receive support

• We serve Fond du Lac and the surrounding 60-mile radius

• All information is kept confidential

• Your nominee will be contacted directly if selected

Nominee's First Name*

Nominee's Last Name*

Nominee's Email Address*

Nominee's Phone*

City/Town* (to verify within 60-mile radius)

Does the nominee know you're nominating them?*

Why are you nominating this person?*

Wellness Areas (Select all that apply): Which areas of wellness is your nominee struggling with?*

Physical Health (chronic conditions, pain, fatigue) Mental Health (stress, anxiety, depression, overwhelm) Emotional Wellbeing (grief, life transitions, burnout) Other (please specify below)

Other:

Your First Name*

Your Last Name*

Your Email Address*

Consent

I confirm that the nominee's contact information is accurate and that they are willing to be contacted by Into the Woods Wellness*

Nominate Someone for Wellness Support

Ready to Make a Nomination?

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