Request a Care Package

From our hearts to yours.

Complete the Form Below

Our care packages are specially designed by sister survivors for patients undergoing chemotherapy or radiation treatment. They contain comfort items like a healing pillow, warm socks, lotion, tea, and more — all at no cost to you.

Name *

Email *

Phone *

Date of Birth *

Gender *
FemaleMaleNon-BinaryChoose not to disclose

Race / Ethnicity *

Shipping Address

Street Address *

City *

ZIP Code *

State *

Treatment Information

Treatment Type *

Treatment Start Date *

Hospital / Facility *

Oncologist or Surgeon — Name and Phone *

How did you hear about Breast Connect?

Disclaimer

By requesting a care package or flowers through Breast Connect, you hereby release and agree to indemnify and hold harmless Breast Connect, Inc. and its members, officers, directors, employees, and agents from and against any and all claims, liabilities, and damages arising from the products you receive or out of the sharing or storage of any information you provide to us and from the interactions with persons with whom you connect through Breast Connect, Inc.

Breast Connect, Inc. has not been established to sell healthcare products, drive opinions, or be a persuasive source. By submitting a request to receive a Breast Connect Heart-to-Heart Care Package, you are authorizing Breast Connect, Inc. to store your information in a database. Your information will not be shared outside of Breast Connect without your written consent.

I have read and agree to the disclaimer above.

What's Included

Heart-shaped Healing Pillow
Warm Socks
Lotion / Aloe
Tea
Mints
Lip Balm
Pen & Journal

* Tennessee Residents Only

This program is currently available for patients in the state of Tennessee.

Sponsor a Package

For $75, give the gift of support and comfort to someone going through treatment.

Sponsor — $75

Breast Connect has been a lifeline through my most difficult storm. The care package and flowers I received were wonderful, but the best is all the love and support of my pink sisters.

Carin G.

Questions? Contact us at contact@breastconnect.org or call (865) 409-0410