Remember Me Bears Request Form – Hospice of the North Coast

Remember Me Bear
Request Form

Where Memories Become Something You Can Hold

These beautiful bears are custom made by dedicated volunteers using favorite articles of clothing of loved ones who have passed. Remember Me Bears offer comfort and support during bereavement and beyond.

Submit this form along with your fabric to:
Hospice of the North Coast
Attn: Hope Bereavement Center
2525 Pio Pico Drive, Suite 301
Carlsbad, CA 92008

We will call you when your bear is ready to be picked up. With questions, call (760) 431-4100.

Name *

First

Last

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Name of Patient *

Male/Female *

Favorite Color *

Profession *

Hobbies *

Branch of Military *

Special Instructions / Notes

Recommended fabrics for best results: • cotton • pajamas | Fabrics we are not able to use: silk • satin • sweaters • t-shirts

Phone

Remember Me Bear Request Form

Where Memories Become Something You Can Hold

Recommended fabrics for best results: • cotton • pajamas | Fabrics we are not able to use: silk • satin • sweaters • t-shirts

Remember Me Bear
Request Form