® PLEASE PRINT THIS FORM AND INCLUDE WITH YOUR SHIPMENT How to admit your American Girl doll Choose ONLY ONE treatment and any additional services (ear piercing and/or hearing aids where available). All treatments include a wellness visit: cleansing of surface dirt from skin*, brushing and re-styling of hair**, 1. Completethisadmissionform.Ifsendingmorethanonedoll,please and tightening of limbs if necessary. completeaseparateadmissionformforeachone. 18" American Girl® doll treatment options 2. Placeyourundresseddollandthisform(ifpayingbycheckormoney (includes historical characters, Girl of the Year™, Truly Me™, and Create Your Own) order,attachpaymenttotheform)inasturdybox. 3. Tapetheprovidedshippinglabeltoyourpackage. Refresh & Renew - $32 (PLEASE INDICATE ALL SERVICES REQUIRED) 4. Shipyourdolltousthroughyourpreferredcarrier. Replace eyes Reattach head Reattach limbs Wellness visit only Note: Pleaseallowtwotofourweeksfortreatment,andanadditional Care & Repair - $44 (PLEASE INDICATE ALL SERVICES REQUIRED) weekforCreateYourOwndolls. Replace one body part CHOOSE ONE: Head Body (torso & limbs) Torso only Limbs only Doll's name Advanced Care & Repair - $88 (PLEASE INDICATE ALL SERVICES REQUIRED) Hair color Eye color Replace two or more body parts CHOOSE TWO OR MORE: Head Body (torso & limbs) Torso only Limbs only Bill to: Adult's first and last name Additional services: Ear piercing - $16 Address Hearing aid(s) - $14 Left ear Right ear Both Apt./Suite (optional) City Prov Postal code WellieWishers™ treatment options Country: Refresh & Renew - $20 (INCLUDES WELLNESS VISIT) Email address Phone # Advanced Care & Repair - $44 (INCLUDES REPLACEMENT OF HEAD AND BODY) Additional service: Ship to (complete if different from “Bill to:” address): Ear piercing - $16 First and last name Bitty Baby™ and Bitty Twins™ treatment options Address Refresh & Renew - $20 (PLEASE INDICATE ALL SERVICES REQUIRED) Apt./Suite (optional) Replace eyes Reattach head Wellness visit only City Prov. Postal code Care & Repair - $24 (PLEASE INDICATE ALL SERVICES REQUIRED) Country: Replace one body part CHOOSE ONE: Head Body Payment method: Invoice will be mailed to purchaser as order confirmation. Advanced Care & Repair - $44 (COMPLETE RE-BUILD OF HEAD AND BODY) Encloseyourpersonalcheck,moneyorder,giftcard,orcreditcardinformationasindicatedbelow. MakecheckspayabletoAmerican Girl. Shipping Check/moneyorder AmericanExpress Discover/Novus Standard shipping and processing FREE Giftcard MasterCard Visa Subtotal: Creditcard(15or16digits)orgiftcard(19digits)number Add 12% of subtotal for Canada delivery fees† Express shipment to Canada + $10.00 per doll For international shipments other than Canada, add $52 Expirationdate CIDnumberorgiftcardPIN – Total: (all prices in US currency) Month Year † Canada delivery fees Include costs paid to a customs broker, enabling delivery to your door) *Skin cleaning will remove most surface dirt from the doll’s vinyl skin but is not likely to remove ink or dye stains. Signatureofauthorizedbuyer **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. Special notes: Questions or concerns? Call us at 800-845-0005 • We cannot guarantee replacement parts will be • Parts replaced through surgery will not be returned. available for dolls archived more than 15 years ago. Comments: • We reserve the right to refuse repairs at any time for • Admission of a complete doll (head and body) is required to any reason. purchase a new head or body. • Shipping and processing fees are non-refundable. • Altered or unidentifiable dolls may not be accepted. • Eyes will be replaced with same color. ® Clip and tape the mailing label to your package to send your doll to the hospital via a traceable method. Send to: ® DOLL HOSPITAL 8350 Fairway Place Middleton, WI 53562 United States of America.