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Is your Child Afraid to Go To the Doctor?

Is your son/daughter scared to go to the Doctor? Does going to the doctor cause a commotion in the household?

If so, we want to help!

We are looking for dynamic kids, ages 3 - 6, who are afraid to go to the doctor for an upcoming episode. We are looking for kids who can speak articulately.

We have a special guest that will help your child to overcome that fear!

Don't miss out on this exciting opportunity!

Tell us your story here:

Please type your contact information below:

first name:	*
last name:	*
birthday:	*
E-mail address:	*
street address:	*
additional address:
city:	*
state:	*
province/Region (if not in U.S.):
zip/Postal code:	*
country:	*
day phone:	*
evening phone:
cell phone:
are you willing to appear on the show:	Yes No *
children's ages?:

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