Missions - MIB Agents

MIB Agent Missions

MIB Agents will host a mission for an osteosarcoma warrior that has been transitioned to hospice care. The warrior will work with our Mission Commander, an osteosarcoma warrior, to develop a mission worthy of the warrior. Sometimes this mission is an item of comfort or entertainment, sometimes it is an experience to share with family but it is always unforgettable.

Hi Agents! I am Alexis Johnson, 27 years old, and born and raised in San Diego, Ca. I am an 11 year cancer survivor, I have had 3 x limb salvages, and above the knee amputee. I am currently in my first year of medical school at the University of Arizona Medical School and aspiring to become a pediatric oncologist. I live a very blessed life and I am fortunate to have a great support system from my huge family and friends. I have many hobbies. I enjoy being active, love baseball, science, and traveling.

I have been involved in MIB for several years now and it holds a special place in my heart. I have also completed several missions and looking forward to working with OsteoWarriors everywhere on their MISSIONS to Make It Better! If we can be of help to you, please contact me at MissionCommander@MIBagents.org.

Mission Request Form

Patient Name

Patient's Birthdate

Shirt Size

Patient's Diagnosis

Diagnosis Date

Is there a medical reason we need to act quickly?

Warrior's Hobbies, Favorite Things

Parent/Guardian Name

Birthdate

Shirt Size

Parent/Guardian Name

Birthdate

Shirt Size

Sibling(s) and Birthdate(s)

Street Address

City

State

Zip Code

Moible Phone

Home Phone

Hospital Name & Address

Treating Physician

Referring Person's Name

Referring Person's Email

Warrior's Caring Bridge or Facebook Page to Share

Has child received an experience or wish from other organizations?

If yes, please explain

Upload a photo of child to be used on mission card

Signature and Date Submitted

Please Note: MIB Agents may contact the child’s treatment facility for clearance if Mission Request involved travel or activity. Submission of Mission Request Form is not a guarantee of mission acceptance. You will be contacted within 48 hours by MIB Agents Mission Commander for more information.

By submitting this form you agree to the release of submitted photo and all photos taken during the mission to be used at MIB Agents discretion on social media and on website and all printed materials. No photo will be used unless the mission is accepted.

MIB Agent Missions

Mission Request Form

Our Very First Mission – Alyssa