Hospital Order Form

Thank you for using the Second Stork on-line order form. This form allows us to insure accuracy and timeliness in supplying hospitals with critical care items for new parents in need. Note that all order quantity boxes REQUIRE completion (even if order quantity is “0”), then simply hit SUBMIT. A volunteer will be in touch soon regarding your delivery.

Items Requested

(Insert quantities. All fields required.)

For new parents with no other option to secure a safe place for newborn to sleep. Quantities are limited, please order only the number that corresponds to parents that would have NO other option or resource to secure a safe place for their newborn to sleep.

for new parents with no new clothing for their newborn as they leave the hospital; supply is limited and, as reported by most hospitals, typically the number of parents that have no newborn clothing is less than half the typical number that need diapers (below). We will deliver an assortment of sizes, or if our availability allows, you can specify the quantity of sizes you prefer below. Total number of layettes may not exceed SIX.

for new parents with limited or no financial resources to secure a supply of diapers and wet wipes in first few weeks. We will deliver an assortment of bags in different sizes, or if our availability allows, you can specify the quantity of sizes you prefer below:

for hospital staff to keep on hand to distribute as they deem appropriate

for hospital staff to keep on hand to distribute as they deem appropriate

Contact Information

Please give us the name and phone number of the person with whom our volunteers should coordinate the pick-up or delivery.

if applicable

If you have additional information or requests to forward to Second Stork, please note above.

Sending