Doll Hospital Admission Form - American Girl
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1DOLL HOSPITAL ADMISSION FORM
Where your American Girl doll goes to get better!
®
Please allow two to four weeks for repairs. Add an extra week for One of a Kind doll repairs.
To learn more about our Doll Hospital, visit .
Date
/
/
Name of doll’s owner
We’re admitting
Hair color
Eye color
(Doll’s name)
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
For WellieWishers™ dolls—Certificate of Good Health • Doll Hospital Gown and Socks • Get Well Card
A la carte service for ear piercing/hearing aid installation excludes wellness service and other items included with repairs.
Type of repair or service:
Admission form
Doll Hospital Admission Process
18" AMERICAN GIRL DOLLS
Bill to:
Place your undressed doll and admission
Total price USD:
form with payment attached, including
REPAIRS
Adult name __________________________________________________
shipping charges, in a sturdy box. Please
New head (same American Girl doll only)
$44
do not wrap your doll in newsprint.
New body (torso and limbs)
$44
Address _____________________________________________________
If sending more than one doll, please
$34
New
torso
limbs
(choose one)
complete a separate admission form for
Apt/Suite ____________________________________________________
Eye replacement (same eye color only)
$28
each one. Tape the mailing label (above)
to your package to send your doll to the
$32
Reattachment of
head
limbs
(choose one)
City ________________________________________________________
hospital via a traceable method.
Wellness visit †
$28
Skin cleaned, hair brushed, hospital gown and certificate, but no “major surgery”
State ____________________________________ Zip _______________
SERVICES
Important information about your repair:
Home telephone (
) ____________________________________
Ear piercing
$16
† Wellness Visit skin-cleaning will remove
most surface dirt from your doll’s vinyl, but
$14
Hearing aid
Left
Right
Both
Cell (
) _______________________________________________
is not likely to remove ink or dye stains.
BITTY BABY ™ & BITTY TWINS ™
Wellness Visit hair-brushing will improve
E-mail address ________________________________________________
New head (same Bitty Baby or Bitty Twin only)
$22
the appearance of the doll’s hair, but will
Doll will be shipped to “bill to” address above unless an alternate address is given below.
not make a well-played-with doll’s hair look
New body (torso and limbs)
$22
brand-new.
Eye replacement (same eye color only)
$18
Ship to
:
(if different from “bill to”)
• All replacements & attachments include skin
Reattachment of head
$16
cleaning & hair brushing at no additional
Adult name __________________________________________________
Wellness visit †
$18
charge.
Skin cleaned, hair brushed, hospital gown and certificate, but no “major surgery”
• Admission of a complete doll (head and
Address _____________________________________________________
WELLIEWISHERS™
body) is required to purchase a new head
Wellness visit †
or body.
Apt/Suite ____________________________________________________
$18
Skin cleaned, hair brushed, hospital gown and certificate, but no “major surgery”
• Altered/unidentifiable dolls may not be
New head & body
$44
(head, torso and limbs)
City ________________________________________________________
accepted
• Parts replaced through surgery will not be
Shipping & processing
$7.95 per doll
For US and its possessions
State ____________________________________ Zip _______________
returned.
If doll is to be shipped to an international address other than Canada, please
add $60.00.
• We reserve the right to refuse repairs at any
) ____________________________________
2-Day
$15
Home telephone (
time for any reason.
Next Day
$20
• Shipping and processing fees are non-
Cell (
) _______________________________________________
Subtotal
refundable.
Sales tax
E-mail address ________________________________________________
We are required to collect applicable sales tax for deliveries to the following states:
AZ, CA, CO, FL, GA, IL, KS, MA, MN, MO, NC, NY, OH, SD, TN, TX, VA, WA, and WI.
Total
(including shipping and tax)
Payment method:
Comments:
Invoice will be mailed to purchaser as order confirmation.
Enclose your personal check, money order, gift card, or credit card information as indicated below.
Make checks payable to American Girl.
MasterCard (16 digits)
Check/money order
Discover/Novus (16 digits)
Gift card (19 digits)
Visa (16 digits)
American Express (15 digits)
Credit card number
CID number or gift card PIN code
Expiration date
–
Month
Year
Signature of authorized buyer
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Parent category: Medical