CANADA DOLL HOSPITAL ADMISSION FORM

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
Bill to:
Total price
USD:
18" AMERICAN GIRL DOLLS
Adult name
REPAIRS
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
Province
$16
Add hearing aid
$14
left
right
Postal Code
Doll Hospital Admission Process
Home telephone
SERVICES
Ear piercing
both
Cell
E-mail address
Doll will be shipped to address above unless an alternate address is given below.
BITTY BABY
New head (same Bitty Baby only)
$22
Ship to (if different from “bill to”):
New body (torso and limbs)
$22
Name
Eye replacement (same eye color only)
$18
Reattachment of head
$16
Address
Wellness visit
$18
Apt/suite
Skin cleaned, hair brushed, hospital gown,
and certificate, but no "major surgery" †
DOLL HOSPITAL
8350 Fairway Place
Middleton, WI 53562
United States of America
Please allow two to three weeks for repairs depending on volume.
To learn more about our Doll Hospital, visit americangirl.com.
®
Where your American Girl doll goes to get better!
Send to:
CANADA 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.
®
SUBTOTAL
City
Add 12% of SUBTOTAL for Canada Delivery Fees*
Province
Shipping & Processing to Canada $7.95 per doll
Express Shipment to Canada + $10.00 per doll
Comments:
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.
W 1008
Important information about your repair:
Postal Code
TOTAL
* Canada delivery fees include costs paid to a customs
broker, enabling delivery to your door.
† 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.
• All replacements & attachments include skin
cleaning & hair brushing at no additional
charge.
All prices in US currency.
• 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