Initial Intake

If yes, please complete our Everglow Box form as well.

Family Intake

Some families may choose not to name, or to share the name of their baby.

If the family consents to any image sharing, direct them to the liability release on our website.

This is a custom made piece of jewelry - partnered with Blessed Mama Keepsakes - that can be made with pieces of remembrance items like breastmilk, cremations, and pregnancy tests.

If yes, please provide the date and its significance.

Yes, please! No, thank you. I'd like to decide later.

This will be the same way that we deliver images.

Record information relevant to chosen contact methods.

The Everglow Box

This form is for approved recipients of an Everglow Box.


The Everglow box is complimentary remembrance keepsake box thoughtfully prepared for families experiencing pregnancy or infant loss. Each box contains meaningful items intended to honor your baby, preserve memories, and provide a tangible reminder of their everglowing little light.


Everglow boxes are provided upon approval by This Little Light and are subject to availability. Contents may vary based on available supplies, individual circumstances, and the needs of each baby. All requests are reviewed by our team before a box is prepared or distributed.

Only requests made with the family's permission should be submitted for approval.