Custom Jewelry Order Form
Custom Orders include a 30 min. Personal Jeweler video chat appointments with EmmaLee to build your perfect piece!
Thank you for order
Email
This email will be used to contact about your order and your video appointment
Full Name
*
First Name
Last Name
E-mail
*
Contact Number
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Area Code
Phone Number
How did you hear about Amber and Haze?
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Website
Facebook
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Etsy
Received as a gift
Received samples
Received from my birth center
Received from my doula
Received from a friend
Order Specifics
Tell us exactly what you want your piece to look like and do for you!
Upload any photos for examples of previous pieces you love!
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What time of day are you available for your video chat?
Type any preferred time; morning, noon, or evening
Choose your preferred Date
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Month
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Day
Year
Date
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