The easiest way is copying and pasting the information on the left into a email, then filling it out.  My email address is:

Or you can download the form by clicking on the link below:

The form for ordering a hat

Name: (I will only put first names on the website and hats unless you want me to include the last name.) 


Please check the color of the hat you would like:  
​ ☐ Navy Blue        ☐ White      ☐ Grey            ☐ Pink        ☐ Dark Green                 
​☐ Yellow              ☐ Orange         ☐ Purple         ☐ Red

​ Please tell me a little bit about yourself.  What are your hobbies and interests?  What would you like me to paint on your hat for you?

To determine who is eligible for a lid, please provide a short, detailed description of your child's condition that is ACTIVELY being treated.

         What is the best way for me to give you your hat?  Please let me know if I should come to the Hospital to drop it off or have it delivered to your home.

*If you want it delivered, leave your address so I can mail it to you. **If you want to have a picture of your child on the website wearing the hat, just send a picture of him/her and I will place it under the PAST HATS section with all of the other hats and kids.