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Top Surgery Supply Form
Top surgery supplies will be lent out to each person for 4 weeks
(the length of time they are typically needed) and will be returned to us afterwards. All items are washed and clean. You must also wash/laundry before returning.
Fill out the form below to get borrowing!
Please only fill out once you have your exact surgery date.
(If you are uncomfortable giving out information and want to know who who are communicating with, you can reach out to organizer Kat (they/them) by email at transsupplylibrary@gmail.com or DM @transsupplylibrary to ask questions and chat further!)
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* Indicates required question
Name
*
Your answer
Pronouns
Your answer
Email and/or phone number (however you prefer to be contacted).
*
Your answer
Date of your surgery (please only fill out this form if you have been given an exact surgery date)
*
MM
/
DD
/
YYYY
Your location (you don't need to provide an exact address at this time if you're not comfortable with that; just a general location).
*
Your answer
Please check off all of the supplies you would like to borrow!
*
Wedge pillow set (image of exact one and sizing). For sleeping and resting.
Mastectomy pillow (very similar to image). For car rides and lounding comfortably. Universal size.
Reusable bent metal straw. Allows you to not lift arms when drinking.
Anti-bacterial soap/wash. For pre and post-op showers.
A couple extra post-op binders. Helpful for allowing you to wash your post-op binder given to you by the clinic, while not being exposed for longer than you should be.
Shoulder strap. Clips onto post-op binder around your shoulder, helps to prevent binder slippage.
Adjustable laptop stand for couch/bed. Exact one ("Bollsidan" from IKEA) pictured.
Required
Are there other supplies or anything else you will need support with (baby wipes, setting up a meal train, rides to-and-from appointments)? Can't guarantee we will be able to help with all other needs, but we can sure try!
Your answer
Supply transportation.
Due to size of supplies, their transport necessitates a car. You can either pick them up (from Sleepy Bones Tattoo, 477 King st E, Hamilton, ON), or we will drop them off to you anywhere within the Hamilton area.
*
I can likely pick up borrowed supplies
I will need them brought to me
Any other questions/comments/concerns at this time?
Your answer
Once you've submitted the request, we'll get back to you as soon as possible, chat further, and sort out the details of getting you the supplies! Happy to answer any and all additional questions or concerns.
And CONGRATULATIONS! Yeet those teets!
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