Wishers & Dreamers - Hospital Doll Gown Request Form
We will send to a child battling medical issues a hospital gown for their little doll/buddy for FREE. Please allow 2 weeks to receive your gown.  We ask that you only request one gown per child. We only fill requests from USA due to cost of shipping to other countries.
Sign in to Google to save your progress. Learn more
First Name of Child to receive gown *
Last Name of Child to receive gown *
Shipping address for gown (We don't ship to Hospitals) *
Street Address
City *
State *
Zip Code *
Country (if outside U.S A. we are unable to ship due to high cost)
Child's gender *
Child's age  (this helps us send age appropriate gowns)
Child's diagnosis
Child's likes (ie..colors, themes,)
Name of requestor *
Relationship to child *
Email address for requestor *
We love to receive pictures of patients with their gowned doll/buddy.  Occasionally we share these pictures on our website/facebook page. *
Do you give your permission for any photos submitted to Wishers and Dreamers to be published?
How did you hear about us? *
Enter the name of: other/Group/Blog/Facebook Page/Friend Name
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.