Doll Hospital Admission Form - American Girl

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					                                                       Doll Hospital aDmission Form
                                                              Where your American Girl doll goes to get better!

                                                                                                                                                                                                                                                                                                            8350 Fairway place, middleton, Wi 53562
                                                                           Please allow two to three weeks for repairs.
                                                                  To learn more about our Doll Hospital, visit

   today ____ /____ /____ name of doll’s owner _________________________________________________
   We’re admitting _______________________ Hair color ______________ Eye color ___________________
                                                     (Doll’s name)

             o Bitty Baby                   o Bitty twin                   o Historical 18"                o Contemporary 18"                o Girl of the Year 18"

                      After repair, which includes skin-cleaning and hair-brushing, your doll will return home with:
                              Certificate of Good Health • Doll Hospital Gown • Doll Hospital iD Bracelet*
                                                                   *ID Bracelet not included with Bitty Baby/Twins

                    type of repair or service:                                                                                   admission form

                                                                                                                                                                                   Clip and tape the mailing label to your package to send your doll to the hospital via UPS or insured mail.

                                                                                                                                                                                                                                                                                                                       Doll Hospital
 18" amEriCan Girl Dolls                                                       total price    Bill to:
 Reattachment             head orlimbs (choose one) $24
                                                                                                  Adult name _______________________________________________________
 Eye replacement (same eye color only)              $24
 New head (same American Girl only)                                   $39                         Address ___________________________________________________________
 New body (torso and limbs)                                           $39
 New        limbs or         torso (choose one)                       $29                         City __________________________________ State _____ Zip ______________

 Ear piercing                                                          $14
                                                                                                  Home telephone (               ) __________________________________________
 Wellness visit                                                       $24
 Skin cleaned, hair brushed, hospital gown,
 and certificate, but no "major surgery"                                                          Cell (           ) _______________________________________________________

 BittY BaBY & BittY tWins                                                                                                                                           __
                                                                                                  E-mail address ___________________________________________________ _
 Reattachment of head                                                  $14
 Eye replacement (same eye color only)                                 $14                    Doll will be shipped to address above unless an alternate address is given below.

 New head (same Bitty Baby or Bitty Twin only)                         $19
                                                                                              ship to (if different from "bill to"):
 New body (torso and limbs)                                            $19
 Wellness visit                                                        $14                        Name ____________________________________________________________
  Skin cleaned, hair brushed, hospital gown, cap
  and certificate, but no "major surgery"
                                                                                                  Address ___________________________________________________________
 shipping & processing            For US and its possessions: $6.95 per doll
                                           For Canada: $16.95 per order

 Most Doll Hospital stays last two to three weeks. If, upon release,
                                                                                                  City __________________________________ State _____ Zip ______________
 you would like your doll returned via RUSH service, please select
 from the options below and check the box on the mailing label.
 Rush Return Shipping
  available, except for APO/FPO addresses. (choose one)
 2-Day                                                                 $15
 next Day/Express mail to Canada                                      $20
  If doll is to be returned to a foreign country other than
  Canada, please call 800-845-0005 for charges.
 Sales Tax
 We are required to collect applicable sales tax for deliveries to the
 following states: CA, GA, IL, MA, MN, NY, TX, VA, WA, and WI.                                    Gift card/certificate no.:
 Total                                                                                            ___________________________________________________________________

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.

                                                                                                    payment method: Invoice will be mailed to purchaser as
                 Doll Hospital admission process                                                    order confirmation. Enclose your personal check, money order,
                                                                                                    gift card/certificate, or credit card information as indicated below.
   Place your undressed doll and admission form with payment                                        Make checks payable to american Girl.
   attached, including shipping charges, in a sturdy box. Please
                                                                                                                                                                                                                                                                                                    RUSH RETURN
                                                                                                                                                                                                                                                                                                    Yes, I purchased

   do not wrap your doll in newsprint. If sending more than one                                               Check/money order                    MasterCard (16 digits)
                                                                                                              Gift certificate                     Discover/Novus (16 digits)

   doll, please complete a separate admission form for each one.
   Clip and tape the mailing label (at right) to your package to                                              American Express (15 digits)         Visa (16 digits)
   send your doll to the hospital via FedEx, UPS, or insured mail.                                   Credit card number
     rush shipping is available, except for apo/Fpo addresses;
                        details listed above.
                 For more information, call 800-845-0005.                                            CID number                              Expiration date           –
                                                                                                                                                               Month        Year
                                                                                         W 0408