FACE MASK REQUEST CONFIRMATION

Please fill out this form again to confirm the exact location where the face masks should be sent. If you are not the individual authorized to accept this shipment, please forward it to that person to fill out the information below.

HOSPITAL/CARE FACILITY SHIPPING ADDRESS*

At this time we are only accepting requests in the United States.

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ALL ORDERS INCLUDE A FREE LOVE YOUR MELON PIN PACK!

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