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®/Bitty Twins® 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
Bill to:
Total price
USD:
18" AMERICAN GIRL DOLLS
REPAIRS
Adult name
New head (same American Girl only) $44
New body (torso and limbs) $44
New
$34
torso
limbs
(choose one)
Eye replacement (same eye color only)
$28
Reattachment of $32
head
limbs
(choose one)
Wellness visit Skin cleaned, hair brushed, hospital gown,
and certificate, but no “major surgery” †
Address
Apt/suite
City
$28
State
Zip Code
Home telephone
SERVICES
Ear piercing
$14
Add hearing aid
$14
left
right
both
Cell
E-mail address
BITTY BABY & BITTY TWINS
Doll will be shipped to address above unless an alternate address is given below.
New head (same Bitty Baby or Bitty Twin 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” †
Shipping & processing
Ship to (if different from “bill to”):
$7.95 per doll
$20
W 1008
Apt/suite
Important information about your repair:
City
† 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 wellplayed-with doll’s hair look brand-new.
State
Next Day
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
(above) to your package to send your doll to
the hospital via a traceable method.
Address
For US and its possessions
$15
Doll Hospital Admission Process
Name
If doll is to be shipped to an international address other
than Canada, please call 800-845-0005 for changes.
2-Day
DOLL HOSPITAL
8350 Fairway Place
Middleton, WI 53562
Please allow two to three weeks for repairs.
To learn more about our Doll Hospital, visit americangirl.com.
®
Where your American Girl doll goes to get better!
Send to:
DOLL HOSPITAL ADMISSION FORM
DOLL
HOSPITAL
Clip and tape the mailing label to your package to send
your doll to the hospital via a traceable method.
®
Zip Code
Comments:
SALES TAX
• All replacements & attachments include skin
cleaning & hair brushing at no additional
charge.
SUBTOTAL
We are required to collect applicable sales tax for deliveries to the following states:
CA, CO, FL, GA, HI, IL, KS, MA, MN, MO, NC, OH, NY, TX, VA, WA, and WI.
TOTAL
• Admission of a complete doll (head and body)
is required to purchase a new head or body.
• Altered/unidentifiable dolls may not be
accepted
• Parts replaced through surgery will not be
returned.
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.
• We reserve the right to refuse repairs at any
time for any reason.
Make checks payable to American Girl.
Check/money order
MasterCard (16 digits)
Gift card (19 digits)
Discover/Novus (16 digits)
American Express (15 digits)
Visa (16 digits)
Credit card number
CID number or gift card PIN code
Expiration date
–
Month
Year
Signature of authorized buyer