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Gift Order Form

Patient's Info

Patient's First Name

Age

Patient's Last Name

My Gift Choice

Patient Being Treated At

Estimated Length of Stay

Guardian's Info

Legal Guardian First Name

Legal Guardian Last Name

Relationship to Patient

Email

Phone

I am over 18 years of age. As the legal guardian, I am legally permitted to sign on behalf of the patient.

I understand this is a free service, and I am opting in. I authorize the disclosure of the information on this form to Toys for Hospitalized Children and its employees only for the purpose of distributing this toy.

Sign me up for feel-good email updates. (Optional)

Your Signature

Happy Kids Heal Faster!

R

O

Call: 718-735-0222

Text: 917-588-2304

Email: office@ToysHC.org

Headquarters-Toy drop-off

824 Eastern Parkway

Brooklyn, New York 11213

Mailing Address

478 Albany Ave #149

Brooklyn, New York 11203

Affiliate Organizations

www.ToysforSimcha.org

Manhattan Office

551 5th Ave. #2500

New York, NY 10176

Florida Address

Toy drop-off and mailing

4938 Sarazen Drive
Hollywood FL 33021

© 2023 Toys for Hospitalized Children is a tax-exempt 501(c)(3) nonprofit organization

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