Comfort Cubs of Hope (COVID-19)
Are you in need of a Comfort Cub due to the ripple effect of COVID-19?  If you are a front line medical employee please include that information in your story or on the last comment field in the form.  ONE cub per household only please.

We only ship within the USA at this time.  If you are in the military we are able to ship to a US Military Address.

If you are a non-medical individual requesting a cub, please fill out this form to provide information about your situation.  We will do our very best to help you out.  We will give as many Comfort Cubs as possible during this pandemic.  As we are hoping to help as many front line workers, we limit this to one per family.

This is made possible by generous donations from people like you.  Please consider making a donation when you are able at https://www.thecomfortcub.org/donate

NOTE: Due to high demand for these cubs shipping may take 4-6 weeks from date of submission.  ONE per household only so that we may provide as many cubs to more families as possible.  Thank you.

Sign in to Google to save your progress. Learn more
About YOU.
Please tell us about you so we understand your story.
First Name *
Last Name *
Email Address *
NOTE: If you do not receive a reply after hitting the SUBMIT button it is because you did not input the correct email address for yourself.
DOUBLE CHECK THAT YOUR EMAIL ADDRESS IS ACCURATE!
Mobile Number (all numbers no dashes) *
Please briefly explain your story/situation (unlimited words): *
Is your situation COVID-19 Related? *
Required
Do we have permission to use your story on social media? *
Shipping Information
Please provide the following shipping information
First Name and Last Name *
Street Address #1 *
Street Address #2
City *
State *
Zip *
Phone (if different than mobile phone above)
Please list how you heard about us *
Required
Please leave any further comments here
Before you hit SUBMIT, we'd appreciate if you FOLLOW US ON Facebook and Instagram.  Thank you!
https://www.facebook.com/TheComfortCub
https://www.instagram.com/TheComfortCub
Donations are always welcomed.  We are a non-profit 501(c)3 charity and are able to provide our therapeutic teddy bears because of generous donations from people like you.  Your email address will be saved for our purposes, we will never share them outside of our company.
Please consider a donation so that we may continue to provide cubs so that others may feel the comfort of our weighted therapeutic Comfort Cub.  https://www.thecomfortcub.org/donate.   To contact us directly please email:info@thecomfortcub.org
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Comfort Cub. Report Abuse
Google Forms