Operation Xmas Jammies Gift Request

Disclaimer *

I understand

We are so excited for our 2023 Operation Xmas Jammies season! Please note that every submission will be reviewed by our team. We will do our best to fulfill every request, however, there is a screening process that will help determine if your child is eligible to receive jammies. We are looking to reach and provide community to those with rare genetic conditions who have experienced limited medical understanding, knowledge and research; misdiagnosis and/or delayed treatment; care coordination challenges and/or lack of medical support; and limited support networks and awareness. Our definition of “rare” is: Less than 1 in 2,000 individuals are affected with their genetic condition in the United States. Submission is open November 1st until November 15th or until all gift boxes are filled (submission date may end sooner than November 15 if we have received a surplus of submissions). Jammies are first come first serve and are sent to those who meet our criteria. Please note that while we have loved sending jammies internationally in the past, we are not accepting international requests this year due to logistical challenges. We appreciate your understanding.

What is the Rare Disease your child has? *

Please note that each child's condition will be reviewed as this program is intended for children with rare genetic disorders only.

How many children are affected by your child’s condition in the United States?

If greater then 2,000 how many children are affected by your child’s condition?

Is there limited medical understanding, knowledge and research of the rare condition your child has? *

Yes
No

Was your child misdiagnosed? *

Yes
No

Did your child receive delayed treatment because of their diagnosis? *

Yes
No

Have you experienced poor care coordination due to your child’s diagnosis? *

Yes
No

Do you experience a lack of medical support because of your child’s rare condition? *

Yes
No

Is there a national support group for your child’s condition? *

Yes
No

Do you know anyone locally with the same condition as your child? *

Yes
No

Contact info for person submitting

Please enter your contact details, so we can reach out to you if we have any questions about the Gift Request.

Name *

First

Last

This is the person submitting the Gift Request that we can contact if we have questions.

Phone Number *

We need multiple ways to contact you incase we need more information about the Gift Request

Email *

Child Info

This information is about the Child receiving the Xmas Jammie Gift Box.

Picture of the Child *

Click or drag a file to this area to upload.

By uploading a photo, you agree for Project 12-04 to utilize this photo in public facing social media, print, and other forms of promotional and educational material for our Operation Xmas Jammies mission.

Child's First Name *

The FIRST name of the child receiving the Xmas Jammie Gift Box

Age of Child *

Gender of Child *

Male
Female
Prefer not to share

Please tell us more about your child you are requesting jammies for: Is there anything about your child’s diagnosis or journey that you would like us to know? What makes your child rare?

Jammie Size (Select a size from dropdown) *

You can specify more details about the sizing in "Special Requests" if you need to. Size Guide

Shipping Address for the Child Receiving the Gift Request *

Address Line 1

Address Line 2

City

State

Zip Code

Okay for us to share? *

Yes
No

By Checking Yes you are confirming that we can share the information you provide about your child on our website, social media, etc.