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Perinatal Loss Comfort Box Order Form 

The United By Loss Foundation provides comfort boxes to mothers and birth givers who have experienced perinatal loss. Its purpose is to help them navigate their loss. We continuously grow our partnerships and supply local hospitals, emergency departments, and OB/GYN offices in DeKalb County, GA, with complimentary comfort boxes.

However, comfort boxes are also available to order online if you reside in the United States. 

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Most comfort boxes include :

  • A copy of The Power of Healing: A Memoir of Loss and Victory by Dr. Simbi Animashaun

  • Journal

  • Aromatherapy candle

  • Aromatherapy shower steamer and bath bombs

  • Baby keepsake bracelet

  • Pregnancy and infant loss pin  

  • Teddy bear

  • Prayer cards

  • A Mother's Grief brochure and additional educational resources!

 

Orders are accepted monthly for shipment the following month. For example, an order request made in July will typically be delivered in early August. We may alter or include more relevant perinatal loss resources as we develop our comfort boxes. 

 

 Please email info@unitedbylossfoundation.com if you have any questions or concerns, require assistance with the form, or would like to request more than the permitted number of comfort boxes for an event. If ordering online, there is a $75 shipping and packaging fee. 

Criteria:

 You must reside in the United States to order a perinatal loss comfort box. 

 

Must have experienced perinatal loss, which includes early loss (before 20 weeks), stillbirth, or neonatal loss (newborn through 28 days of life). 

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 Please pay the $75 fee for shipping and packaging expenses.

 

Order Form

Name*

Street Address*

City*

State/Province/Region*

Zip/Postal Code*

Email Address*

Phone*

Date of Loss*

Baby's Gender*

Type of Perinatal Loss*

Select an option

Consent Statement *

Please share additional information about your loss. *

How did you hear about us?*

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