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Metro Detroit Share Keepsake Box/EPL Bag Order
Order form for Keepsake Box/Early Loss Bags
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FACILITY NAME
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Facility Address
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Facility City/State/Zip
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Contact Name
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Contact Phone #
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Contact Email
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How many keepsake boxes (designed for 20 wk +) do you need? These come 10/box mixed gender
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How many Early Pregnancy Loss Bags do you need (designed for <20 wk gestation) losses? These come 20/box
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Can you pick up in Taylor, MI or do you need delivered?
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No
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Any Special Instructions/Details/Hours of Operation
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