Download Report

/
(Date)
/
, Name of doll’s owner
We’re admitting
Hair color
(Doll’s name)
Eye color
All repairs include complimentary wellness service. After repairs, dolls are returned with:
For 18” Dolls - Certificate of Good Health • Doll Hospital Gown and Socks • Doll Hospital ID bracelet • Get Well Card.
For Bitty Baby Dolls - Certificate of good health • Doll Hospital Gown and Cap • Get Well Card
A la Carte services for ear piercing/hearing aid installation excludes wellness service and other items included with repairs.
Type of repair/service:
Admission form
Total price
USD:
18” AMERICAN GIRL DOLLS
Bill to:
REPAIRS
Adult Name
New head (same American Girl only) $44
New body (torso and limbs) $44
Address
Eye replacement (same eye color only)
$28
Reattachment of $32
Cityy
$28
Province
head
limbs
(choose one)
Wellness visit Skin cleaned, hair brushed, hospital gown,
and certificate, but no “major surgery”
p
Home telephone
SERVICES
Ear piercing
$14
Cell
Add hearing aid
$14
E-mail address
left
right
Postal Code
both
Doll will be shipped to address above unless an alternate address is given below.
BITTY BABY
Ship to (if different from “bill to”):
New head (same Bitty Baby only)
$22
New body (torso and limbs)
$22
Eye replacement (same eye color only)
$18
Reattachment of head
$16
Wellness visit $18
Skin cleaned, hair brushed, hospital gown,
and certificate, but no "major surgery"
Name
Address
Cityy
Province
Postal Code
Comments:
SUBTOTAL
Add 12% of SUBTOTAL for Canada Delivery Fees*
Shipping & Processing to Canada $12.95 per doll
Express Shipment to Canada** + $10.00 per doll
TOTAL
* Canada delivery fees include costs paid to a customs
broker, enabling delivery to your door.
**Express Shipping will result in your order arriving
approximately 2 days faster than an order with
standard shipping. We are unable to guarantee
an exact delivery date.
®
Today,
Please allow two to three weeks for repairs.
To learn more about our Doll Hospital, visit americangirl.com.
Gift card number with pin
Important information about your repair:
• All replacements & attachments include skin cleaning & hair brushing at no additional charge.
• Wellness Visit skin cleaning will remove most surface dirt from your doll’s vinyl, but is not likely to remove ink or dye stains.
• Wellness Visit hair brushing will improve the appearance of the doll’s hair, but will not make a well-played-with doll’s hair look brand-new.
• Admission of a complete doll (head and body) is required to purchase a new head or body.
• Parts replaced through surgery will not be returned.
• We reserve the right to refuse repairs at any time for any reason.
• All prices are in US Dollars.
Payment method: Invoice will be mailed to purchaser as order
confirmation. Enclose your personal check, money order, gift card, or credit
card information as indicated below.
Doll Hospital Admission Process
Place your undressed doll and admission form with payment
attached, including shipping charges, in a sturdy box. Please do
not wrap your doll in newsprint. If sending more than one doll,
please complete a separate admission form for each one. Clip
and tape the mailing label (at right) to your package to send
your doll to the hospital via Canada Post mail.
For more information, call 800-845-0005.
Make checks payable to American Girl.
Check/money order
Gift card
American Express (15 digits)
Credit card number
CID number
W 1008
MasterCard (16 digits)
Discover/Novus (16 digits)
Visa (16 digits)
–
Expiration date
Month
Year
Yes, I purchased
RUSH RETURN
SHIPPING
DOLL
HOSPITAL
Clip and tape the mailing label to your package to send your doll to the hospital via UPS or insured mail.
Where your American Girl doll goes to get better!
®
DOLL HOSPITAL
8350 Fairway Place, Middleton, WI 53562
CANADA
DOLL HOSPITAL ADMISSION FORM