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Bills Healthcare Doodle Order Form

Please read before placing your order. Tees are $15 / Crewnecks are $25. Free delivery to any units at Strong Memorial Hospital or if you live within 10 minutes of the hospital. For an additional $5 you can have your order shipped to you.

Name

*

Email

*

Phone Number

*

Delivery method

*

Delivery method

FREE - SMH units

Additional $5 - shipped to home address

Unit # for SMH delivery

If you chose shipping, what is your address?

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Tee or Crewneck?

*

Tee or Crewneck?

Tee - Ash ($15)

Crewneck - Ash ($25)

Size

*

Size

Small

Medium

Large

XL

2XL

3XL (Add $4.00)

4XL (Add $4.00)

Payment Type

*

Payment Type

A

Venmo

B

Cash App

Payment is required to secure your order. Production of your order will start once payment is received. Please allow 1-2 weeks for your order to be made.

Please send payment VIA:

Venmo: Amanda-Boss-5 Cash App: $AmandaBoss5
Please print your full name in the payment note.

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Comments or questions? Please fill out below or reach out to me via text: 585-813-7074.