Care package request

Comfort delivered with compassion.

This application is for a complimentary care package following miscarriage, stillbirth, neonatal loss, or infant loss within the previous 12 months. Packages may be mailed anywhere in the United States.

Before you begin

The loss must have occurred within the previous 12 months.
The applicant must be the baby's parent or legal guardian.
Packages are limited to one per recipient and household for the same loss.
A complete United States mailing address is required.
We gently ask for one document confirming the loss and date so we can review eligibility.
Approval and delivery depend on available funding, supplies, and shipping capacity.

If your loss occurred more than one year ago, you are not eligible for a complimentary care package, but UMLF's free grief resources and support communities remain available.

Your information

Legal name Preferred nameEmail address Telephone number

Mailing address

Street address Apartment, suite, or unitCity State ZIP code

Loss information

Date of loss Must be within the previous 12 months.Type of loss Baby's name, if you wish to share

Package information

Delivery notesHow did you hear about UMLF?

A document confirming your loss and date

To help us review your request with care, please share one document that confirms your loss and the date. This may be a hospital record, death or stillbirth record, obituary, or funeral-home document. We will review only the information needed to confirm eligibility.

Upload a PDF, JPG, PNG, or WEBP file smaller than 10 MB. Black out Social Security numbers, insurance identification numbers, account numbers, unrelated diagnoses, and medical details UMLF does not need.

Choose file Do not email this document separately.

Required acknowledgments

I confirm that I am the baby's parent or legal guardian.I understand that complimentary packages are limited to one per recipient and household for the same loss.I certify that the information provided is true and complete to the best of my knowledge.I consent to UMLF reviewing this information for my request and have read the Privacy Notice.

Electronic signature—type your legal name

Required fields are marked with an asterisk. Submission does not guarantee approval, payment, or delivery.