November 20, 2013 admin

Send Mastectomy Basket

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WHO IS A CANDIDATE?

PRE-OPERATION MASTECTOMY PATIENTS

Our Bosom Buddy Baskets are personally created by a small group of caring women. The Baskets are specifically made for Pre-Operation Mastectomy Patients awaiting breast cancer mastectomy surgery and are designed to be most useful during the First Five Days Post Operation with items used in the immediate recovery process following mastectomy surgery.

Our Bosom Buddy Baskets are Not designed or intended for patients that have already had Mastectomy surgery or other breast cancer treatments such as lumpectomies, chemo or radiation.

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HOW DO I SEND A BOSOM BUDDY BASKET?

$150 PROVIDES 1 BOSOM BUDDY BASKET

We provide Bosom Buddy Baskets to many hospitals we participate with through our fundraising efforts. We are a very small non-profit organization trying to keep up with high demand. The number of baskets we can deliver is limited by our financial and physical restraints. Therefore, from time to time we may have to limit the fulfillment of basket requests. You will be notified if we will be unable to send the basket.

*Please Consider Making a Tax-Deductible Donation.

IF YOU OR SOMEONE YOU KNOW ARE A CANDIDATE, PLEASE COMPLETE THE BOSOM BUDDY BASKET REQUEST FORM BELOW.

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BOSOM BUDDY BASKET REQUEST FORM

    Diagnosis - Our Bosom Buddy Basket is a surgery recovery basket created specifically for mastectomy surgery patients and not suited for other treatments such as lumpectomy, chemo or radiation. Please bear in mind that we are a small non profit and we need your help to ensure that each of our Bosom Buddy Baskets are given to the women they are designed help and comfort in the right time of their journey. Thank you for your kind consideration of placing an order for only those patients Awaiting Mastectomy Surgery.

    Date of Mastectomy:

    Hospital Name Where Having Surgery (We may already be delivering a basket to her in an area hospital.):

    Donation Amount: We are a small organization trying to keep up with demand. We realize that you may not be able to provide funds for this basket, but please consider having a fundraiser or obtaining sponsorships for The IIIB's Foundation so we can continue to Keep the Candle Glowing for all Bosom Buddies in need. We can't continue to serve women without financial support.
    $150- cost of 1 Bosom Buddy Basket$500$300$75$50$25-covers average delivery costOther

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    FIRST NAME of Basket Recipient:

    LAST NAME of Basket Recipient:

    Country of Delivery: USOther

    Basket Recipient Street Address 1:

    Basket Recipient Street Address 2 (if applicable):

    Basket Recipient Street Address 3 (if applicable):

    Basket Recipient City: State: Zip Code:

    Basket Recipient Phone: (Please enter your phone if you do not have theirs)

    Phone Extension: (if applicable):

    We cannot deliver to any hospital that we are not connected to as the basket gets lost in transit.
    To confirm this is a Residential Address, Please check "1" - As We Do Not Deliver to PO Boxes: 1

    Basket Recipient Email: (Please enter your email if you do not have theirs)

    SENDER's INFORMATION:

    Your FIRST NAME:

    Your LAST NAME:

    Your Street Address 1:

    Your Street Address 2 (if applicable):

    Your City: Your State: Your Zip Code:

    Your Email:

    Your Phone:

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    (Required) HOW DID YOU HEAR ABOUT US? Please let us know who referred you:

    Individual Name:

    Facebook Group Name (full facebook group name required):

    Other Referral:

    NOTE TO THE IIIB's FOUNDATION:

    1) Please use "SEND REQUEST BUTTON" to Place Basket Order

    THEN

    2) You will be directed to the PayPal "MAKE A DONATION PAGE" where you can Make A Donation.

    Thank you for Thinking of The IIIB's Foundation and helping to Keep The Candle Glowing!

    Please use link to make a donation to The IIIB’s Foundation.