Get Support · Care Baskets

Care Basket Request

Request a care basket for a family facing a complicated pregnancy, a difficult delivery, or the loss of a baby. Each basket is handcrafted and filled with thoughtful items that bring comfort and hope. A parent, friend, family member, or nurse may request one on a family's behalf.

Applicant information

Your contact details so we can reach you about this request.

Full name *

Email address *

Phone number *

Address to deliver the basket *

I am applying as *

The family being helped

If you're applying for someone else, tell us about them. If this basket is for you, write "same as above."

Family / recipient name

Hospital or clinic

City & state

Due date or date of loss

Your situation

Share as much or as little as you're comfortable with. There are no wrong answers.

Briefly describe your circumstances *

How soon is the basket needed?

A few last things

How did you hear about us?

Referred by (name, if any)

Anything else you'd like us to know?

Back to Get Support

Your information is sent privately to the foundation and is never shared. Please don't include Social Security or bank account numbers here — we'll request anything further directly if it's needed.

Prefer to request another way? Email us at ourclairefoundation@gmail.com.

What happens next

We'll be in touch with care

After you submit, a member of our team reviews your request and reaches out personally. There is no cost, and every request is handled with compassion and confidentiality.