Request a Basic Bear - Phoenix Bears

Simplified Form. Simple Bear. Comfort made Simple.
Request a Basic Phoenix Bear weighted to your baby’s weight with no add-ons.
Note: We only ship to addresses within the USA at this time.

*If you would like monogramming, angel wings, or other add-ons (fees apply) please CLICK HERE to fill out our form with more options.*

Only the bereaved parent can request a Phoenix Bear. Once your form is received, you will be placed on our Wait List. *

I confirm I am the parent of a baby who has passed away, and agree to allow Phoenix Bears to use pictures of my Phoenix Bear on their website & social mediaAt this time there is a limit of 1 Phoenix Bear per baby. If you lost multiples you will need to fill out a form for each loss.

Your Name (First & Last) *

Email Address *

Confirm Email Address *

Street Address *We are currently only accepting orders from the U.S.

City *

State *

ZIP Code *

Baby's Full Name *Enter First Middle & Last Name (if un-named, you can enter nickname or "N/A")

Baby's Gender *

Baby's Weight (ex: 5lbs 4oz) *How much your Bear will weigh* *If weight is unknown due to miscarriage, please enter baby's gestational age (we will then use average weight for that gestation for your bear).

Baby's Length (in inches) *

Date of Birth or miscarriage *

Date of Passing (If after DOB)

If after DOB

Theme, Colors, Patterns that you associate with your baby *We cannot guarantee this, but will do our best to accommodate up to 2 requests.

Express Pass (If yes, you will also need to buy your own base bear from our Amazon Wishlist)NoYes (Add $40 Donation)Reduce your time on the waitlist by choosing your own bear from our Amazon Wish List and sending it to us

Base BearI will buy my own base bear from your Amazon WishlistChoose my base bear for me

Base BearI will buy my own base bear from your Amazon Wishlist

Bear Fur Color - 1st choice *

Bear Fur Color - 2nd Choice *choose a different color than your 1st choice

Additional InformationEnter any information you want us to know including but not limited to: Color preference for your bear's fur (light, medium, dark, or colorful). Your baby's story (if you want to share it with us). Etc.

Required Waitlist fee *Phoenix Bears Waitlist Fee - $25

How did you find out about Phoenix Bears?

Receive Notifications?

Keep me updated with Phoenix Bears News!I'd like to learn more about Volunteer Opportunities

Donate to Phoenix Bears? *

Discount Code

Total Charge

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Applied 15% discount

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Applied 10% discount

Total After Discount

Note: Please fill in all the required (*) fields - once you do, the "Pay" button will appear below.

Calculations

DiscountFree Embroidery $7

Total After Discount