Team Michelle Care package request form 
Team Michelle Care Packages are for anyone going through breast cancer diagnosis, treatment or post treatment that could use a little pick me up! Please complete form and a care package will be sent (or ready for pick up) to be delivered to your survivor.  Questions please text Michelle at 949-584-7027
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Email *
Your name *
Your Phone Number  *
Name of recipient of care package *
Mail or Hand delivered (pick up care basket in Silverado, CA)
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Address of Recipient  *
Additional comments/info
A copy of your responses will be emailed to the address you provided.
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