Contact Us Contact Form 11.08.18 (1) General Inquiry Form *If you are interested in donating a wedding gown to assist the Angel Gown® program, please review the Wedding Gown Donation FAQs.Name* First Last Email* Phone*I am a...* Parent/Family Member Current resident of the DFW metroplex area and would like to volunteer Hospital Address* Street Address Apartment Information City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code I am interested in being a NICU Helping Hands volunteer. Please contact me about volunteering for the following programs: Project NICU (DFW Metroplex Only) Administrative Assistance (DFW Metroplex Only) I am a local (DFW Metroplex) business owner and would like to discuss ways to help I would be willing to help with data entry and shipment verification.This requires your physical presence at our Bowie Blvd warehouse location. Yes, I am available during the weekday Yes, I am available in the weekday evening Yes, but I am only available on the weekends Thank you for your interest in becoming a member of our team of volunteer seamstresses with our nationally trademarked ANGEL GOWN® PROGRAM. At this time we are not accepting seamstress applications. To be notified when our application process will reopen, please subscribe to our newsletter newsletterI am available:Choose all that apply. Weekdays between 8am-12pm Weekdays between 12pm-4pm Saturdays 8am-12pm Saturdays 12pm-4pm Other Volunteer Availability Notes:* I am requesting:* Financial Assistance One-on-One Mentoring An Urgent Angel Gown The hospitalization of a baby in the NICU can leave a family financially unprepared. If you are a current NICU family experiencing financial difficulty we may be able to assist you through our gift card program. Please let us know what type of assistance you need. Someone on our staff will contact you as soon as possible.Hospital Name* Contact Name & Title* Contact Phone*Contact Email* Hospital Address* Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Social Worker Name* Social Worker Email* Social Worker Phone*Our hospital is requesting:* Information on Project NICU Angel Gown® Garments How many infant losses do you have in your hospital annually?*Please include all loss so that we can determine number of gowns you will need on an annual basis (e.g. fetal demise, stillborn, pre-viable, NICU losses, lethal congenital anomalies, etc).Does your hospital have both L&D and a NICU? Yes, both L&D and a NICU. L&D only. NICU only. Neither L&D or a NICU. Additional InformationWe are saddened that anyone needs an Angel Gown®, but we are honored to provide your precious child with a garment that has been lovingly made by a volunteer seamstress from a donated wedding gown. If you are requesting a garment on behalf of a friend or family member who has lost their child please be sure to confirm all information related to the gestation/age and weight of the baby. Please insure the accuracy of the shipping address you are providing before filling out this form. Urgent requests are processed by 3pm Monday-Friday. Requests received after 3pm will be processed the next business day. Requests received before 3pm Monday – Friday will be shipped in the afternoon via two day FedEx. Requests received before 3pm on Thursday will arrive via two day FedEx on the following Monday. Requests received before 3pm on Friday will arrive via two day FedEx on the following Tuesday. Requests received on Saturday and Sunday will be processed on Monday. The cost of shipping an Angel Gown® garment via two day FedEx is currently provided by NICU Helping Hands through generous donations from families, friends and other supporters. We are unable to cover the cost related to overnight shipping, however families requesting overnight service will be provided pricing and payment options to cover this service when needed. Thank you for your understanding.Baby's Weight*Our garments and wraps are made for babies weighing only ounces up to 10 lbs. We do not have garments for babies over 10 lbs. The gestational age of the baby at the time death was*If the baby was born before 40 weeks gestation please list the exact gestation of the baby (e.g. 24 weeks). If the baby was full term please list that as well (40 weeks). Hospital Where Baby Passed Away* Family Name (If different from the person submitting this form.) This gown is needed for a baby*girlboytwin boystwin girlstwin boy and girltriplets girlstriplets boystriplets girl, girl, boytriplets boy, boy, girlDate of Funeral Service*It is very important that you give us an exact date for the service so we know exactly when the gown is needed. The date of the funeral service lets us know exactly when the garment is needed for the service. We will not ship a garment without this information. Format: MM/DD/YYYY MM slash DD slash YYYY Shipping Address*Do not list a hospital shipping address. Delivery can be delayed when items are shipped to hospitals. The best place for us to quickly ship a garment is to a home address or funeral home. Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Shipping Options* Two day shipping via FedEx provided at no charge. Overnight shipping via FedEx. The cost of shipping an Angel Gown® garment via two day FedEx is currently provided by NICU Helping Hands through generous donations from families, friends and other supporters. We are unable to cover the cost related to overnight shipping, however families requesting overnight service will be provided pricing and payment options to cover this service when needed. Thank you for your understanding. Your Mailing Address* Street Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Hospital Baylor All Saints Cook Children’s Harris Methodist Downtown Preferred Method for Mentor to Contact You:* Phone Email Other Which best describes your need for a mentor?* I have experienced the loss of a child I currently have a child in the NICU My child has been discharged from the NICU Gift Card Request: Gasoline Grocery Restaurant NICU Baby InformationBaby's Name(s): Gestational Age(s): Birth Date(s): General Overview: (diagnosis info, length of stay, special needs, family challenges, etc)*Do you have older children?NoYesOlder ChildrenHow many older children do you have?*123More than 3Child 1: Name* Child 1: Age*Child 1: NICU Stay?*NoYesChild 1: NICU Info (Gestational Age, Weight, etc) if applicable:*Child 2: Name* Child 2: Age*Child 2: NICU Stay?*NoYesChild 2: NICU Info (Gestational Age, Weight, etc) if applicable:*Child 3: Name* Child 3: Age*Child 3: NICU Stay?*NoYesChild 3: NICU Info (Gestational Age, Weight, etc) if applicable:*Additional Children*Please enter their names, ages and NICU information if applicable.Baby InformationGestational age of your child at the time of loss Please feel free to share any relevant information that will help us select an appropriate mentor for you (ex. miscarriage, prenatal loss, diagnosis, cause of death, etc.):Was this a multiple or singleton pregnancy? Multiple Singleton Did you experience a single loss or multiple loss? Single loss Multiple loss Are there surviving siblings from this pregnancy? Yes No Do you have any older children?NoYesNICU Baby InformationBaby's Name(s): Gestational Age(s): General Overview: (diagnosis info, length of stay, special needs, family challenges, etc)*How many older children do you have?*123More than 3Birth Date(s): Child 1: Name* Child 1: Age*Child 1: NICU Stay?*NoYesChild 1: NICU Info (Gestational Age, Weight, etc) if applicable:*Child 2: Name Child 2: AgeChild 2: NICU Stay?*NoYesChild 2: NICU Info (Gestational Age, Weight, etc) if applicable:*Child 3: Name Child 3: AgeChild 3: NICU Stay?*NoYesChild 3: NICU Info (Gestational Age, Weight, etc) if applicable:*How may we help?*EmailThis field is for validation purposes and should be left unchanged. Newsletter Signup Name First Name Last Name Email PhoneThis field is for validation purposes and should be left unchanged.