Hug Wraps® Order Form

Please note that the Hug Wraps® pattern was created for and by Hug Wraps® and is NOT available for purchase.

This order form is only to be used to order a Hug Wrap for yourself or a loved one.

Name of Individual Placing Order*
First Last
What is your relationship to the patient? The patient is my...*
Example: friend, sister, uncle, parent, etc.
Please Provide the Phone Number of Individual Placing the Order
Email Address of Individual Placing Order*
Address of Individual Placing Order*
Street Address City State / Province / Region ZIP / Postal Code Country

Please enter the address of the individual placing the order. The shipping address of the recipient will be entered later.
Hug Wraps® Shipping Information
Please provide the name and address of the individual the Hug Wrap is to be shipped to.
Who is this Hug Wrap to be shipped to?*
First Last
Address where Hug Wrap is being shipped.*
Street Address City State / Province / Region ZIP / Postal Code Country
Hug Wraps® Recipient Information
Patient's Name*
First Last

Please enter the name of the patient receiving the Hug Wraps®
Does the patient have an upcoming surgery? Please let us know the date of the surgery.
Approximate Age of Patient*
Patient's Height*
Patient's Diagnosis (Cancer Type)
Hug Wraps® Sizing and Fabric Information
Your Hug Wrap will be created in a standard mid-thigh length. If you require a longer length, please see additional options below. Floor length Hug Wraps® are NOT available.

Fabrics: The fabrics available to us are always changing. We ask for three color choices and three pattern theme choices, to guide us in choosing a fabric for you. Typical fabric pattern themes include: flowers, butterflies, animals (or a specific animal), sports (or a specific sport), musical instruments (or a specific instrument), animal prints, country music and multi-color swirls.
Patient Description*
Childrens sizes will be displayed when Child is chosen from the Patient Description list.
Build of Patient*
This information will help us better gauge the size of your Hug Wraps®.
ADULT Sizing*
Please Do NOT order a size larger than you need. Hug Wraps are already cut to be roomy and comfortable. They are not tight or form fitting.
CHILD Sizing
1st Choice - Fabric Color
Please enter your first choice for fabric color.
1st Choice - Fabric Pattern/Theme
Please enter your first choice for fabric pattern/theme.
2nd Choice - Fabric Color
Please enter your second choice for fabric color .
2nd Choice - Fabric Pattern/Theme
Please enter your first choice for fabric pattern/theme.
3rd Choice - Fabric Color
Please enter your third choice for fabric color.
3rd Choice - Fabric Pattern/Theme
Please enter your third choice for fabric pattern/theme.
Custom Options (Additional Fee will Apply for Each Option)
Customize your Hug Wraps® with the following options. Please note that these options are available for an additional donation. Please note that floor length Hug Wraps® are NOT available.
Please Add (Choose All that Apply):
Inside Pockets
Knee Length
Inside Pockets can hold items like surgical drains, tubing or insulin pumps. Thigh Length Hug Wraps® are best for Breast Cancer patients. Knee Length are perfect for patients with ovarian, colon or pancreatic cancer.
Important Note...
Upon receiving a Hug Wraps®, Please wash your Hug Wraps® immediately before wearing. It can be washed in warm or cold water. DO NOT add chlorine bleach as it will fade the vibrant colors. Tumble dry and hang it up immediately.
Have any additional thoughts you'd like to share? Please use the space below...
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