Hospital Gown Request
This form is for Hospitals and Medical Facilities to request gowns.  Please complete the request and allow 2 weeks for shipping. Standard request is 20 gowns. ALL request must have your Hospital email.
Sample of Wishers and Dreamers Gowns
Name of Hospital *
Your First Name *
Your Last Name *
Your title *
Your Field of Study/Department *
Your Phone Number *
Shipping Address *
City *
State *
Zip Code *
Notes/ Messages/ Special Shipping Information
How did you hear about Wishers and Dreamers, Inc? *
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