Request Your Phoenix Bear – Outside the USA

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The form below is for bereaved parents who need their Phoenix Bear shipped outside the USA!

*Note: We only embroider in English

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IMPORTANT: This form is for Phoenix Bears to be shipped outside the USA. If you need yours shipped within the USA please CLICK HERE!
*For multiple losses, please fill out one form for each baby if you want a bear for each baby. If you’d prefer one angel bear holding multiple 2″ – 2.5″ baby bears, please fill out one form and put that information in the additional information section.

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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 *

Email Address *

Confirm Email Address *

Street Address *

Apartment, suite, etc

City *

State *

ZIP Code *

Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabwe

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

Baby's Gender *SELECT OPTIONBoyGirlUnknown

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 *

Date of Birth or miscarriage *

Month/Day/Year

Date of Passing (If after DOB)

Month/Day/Year

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

Angel Wings *Yes ($7)No

Attached Blanket *YesNoeach Phoenix Bear comes with a blanket attached to it's hand unless you opt out of this

add-embroiderySELECT OPTIONNo embroideryYes, embroidery BOTH Blanket & Belly Patch (+$14)Embroidery ONLY Blanket (+$7)Embroidery ONLY Belly Patch (+$7)

Embroidery for Belly Patch (up to 2 names)What you enter here will be exactly what is embroidered. If you don't desire any embroidery, type "n/a". NOTE: We do our best to fulfill requests but we can not guarantee more than one name will fit. If your baby has 2 first names such as Mary Beth, please note this in additional information section & we will do our best to include both first names. If the names are too long, we may only be able to include the first name. It is uncommon for 2 names not to fit.

Embroidery for Blanket ~ Up to 3 lines but this depends on how many characters are in your requestEnter exactly what you want embroidered. Example: FULL NAME (1st) WEIGHT & LENGTH (2nd) DOB (3rd). If none, enter N/A. NOTE: We will do our best to fulfil requests. However, there is a limited amount of space so we can not guarantee there will be room for your request.

Bear's Main ColorSELECT OPTIONNo preference (choose for me)White / Cream (off white)Light Tan / TanMedium-Dark BrownGray (light or dark)Colorful (multi-color or solid pink or blue)color preference

Choose a Different Color in case your First Choice is not availableSELECT OPTIONNo preference (choose for me)White / Cream (off white)Light Tan / TanMedium-Dark BrownGray (light or dark)Colorful (multi-color or solid pink or blue)color preference

Additional InformationEnter any additional information you want us to know including but not limited to: If your baby's first name includes more than one name (ex: Mary Beth). Your baby's story (if you want to share it with us). Etc.

Required waitlist feePhoenix Bears Waitlist Fee - $25

Express Pass (If yes, you will also need to buy your own base bear from our Amazon Wishlist) *Yes (Add $40 Donation)NoReduce 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 Wishlist

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

Would you like to donate to Phoenix Bears? *SELECT OPTIONNo thank you, I can not afford to donate at this timeYes, I'll Donate $25Yes, I'll Donate $50Yes, I'll Donate $75Yes, I'll Donate $100Yes, I'll Donate $150Yes, I'll Donate $200Phoenix Bears is run solely on donations. Any donated amount over the expense of your custom bear will be donated to the next bereaved parent on the waitlist.

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

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Applied 15% discount

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Applied 10% discount

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

Calculations

DiscountFree Embroidery $7

Total After Discount

Submit

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