Ishan Gala Foundation

Comfort Package Request form

* First Name

* Last Name

* Email

* Mobile Phone

Mailing address (only required if package is to be mailed)

Are there any specific items you would like to request? Please include the name of child or teen you are requesting the item for.

* Please tell us a little about why are requesting a comfort package?

If you are located in Charlottesville or receive treatment at UVA, we will hand deliver your package. Please provide a good day/time or next appointment at UVA for delivery.

Other notes or comments

* Who are you requesting the comfort package(s) for?

Name of specified child/teen from above

As a part of our Extra Mile Program, we provide comfort packages to fighting families who live in Virginia throughout the entire treatment including maintenance.

There is no wrong reason to request one, whether it be celebrating a big moment, provide comfort during a particularly rough time, a special occasion for siblings, or just because it would bring a smile to their faces.

What's in a comfort package? We tailor each package using your child's interest, hobbies and favorite things provided by you. If it's been over a year since you first registered with us, please be sure to provide us updated information for each child.

Examples of what may be included:

Book/activity books/guided journals

Candy/snacks

Toys

Favorite team memorabilia

Jewelry

Games

Crafts

Coloring books/supplies

Gaming gift cards

Shopping gift cards (for teens)