CUDDLE CARE Treatment Questionnaire

1

Order ID

2

Your Name* This field is required.

First Name

Last Name

3

E-mail* This field is required.

example@example.com

4

Phone Number* This field is required.

Include ext.

5

Date* This field is required.

6

Stuffed Friend's Name and Height* This field is required.From bottom of foot to the top of head (not ears). Measurements in inches, please.

7

Please select all services you require. * This field is required.Total cost of services will be based on Stuffed Friend's size, age, condition, extent of work needed, and other similar factors.

CLINIC: Repairs, Reconstruction, and Parts Replacement

SPA: Cleaning and Restoration

CAFÉ: Stuffing, Weight Pellets, and Sounds

EMERGENCY: Immediate Need. Rush Fees may apply

8

Please detail all treatment needed.* This field is required.This helps us estimate the total cost of treatment prior to meeting the Stuffed Friend

9

IMPORTANTIt has come to our attention that some of our emailed responses have been going to Spam/Junk Folders. Please regularly check these folders for responses from CUDDLE CARE.

10

I HEREBY GRANT CUDDLE CARE the right to use all photos and/or recordings from my Stuffed Friend's treatment FOR DISPLAY, PUBLICATION, RELATED WEBSITE AND BLOG USE, PROMOTION, AND/OR PEER REVIEW. I understand that although I have full rights to print and share the medias which result from my Stuffed Friend's treatment in any way and in any medium, they remain the intellectual property of CUDDLE CARE.

11

TERMS AND CONDITIONS ACKNOWLEDGEMENT
I, Your Name , agree that by submitting any Stuffed Friend or other materials to CUDDLE CARE for their services, I confirm CUDDLE CARE has permission to perform the services agreed upon on this form at the time of Drop-off. Any additional work or changes thereafter will be agreed to and signed for via email, as well as incurring any additional charges (if applicable). In the unlikely event of any loss or damage by CUDDLE CARE, I acknowledge my recovery is limited to the the costs of services agreed upon. Any Stuffed Friend still in CUDDLE CARE's possession after 60 days of confirmation of work completed and several attempts to contact, unless otherwise agreed upon, the Stuffed Friend will be considered abandoned. I understand that any abandoned Stuffed Friend may be subject to adoption or taken apart by CUDDLE CARE for materials.

12

Full price of treatment

Clear

13

Signature - Approval and Dropoff

Clear

14

Signature - Pickup confirmation

Clear

15

Notes