Restock Request Form for sensory bag

This is a restock request form intended exclusively for verified service providers who have previously received our sensory support bags. We’ve chosen not to offer a standard “add to cart” option to help ensure these items are reserved for EMS, first responders, and care teams actively using them in the field. This helps us prevent misuse and ensures our resources continue reaching those who truly need them. If you’re requesting a restock, please fill out the form below so we can verify your information and fulfill your request as soon as possible.

Name *

Department/ Service *

Service Code (unique code given to the service upon initial order) *

Email address *

Please specify how many of each item are needed *

(Optional) If needing communication cards, please let us know if you would like added personalization

(Optional) Select a Date you would like the restock by

(Optional) Anything else you’d like to tell us about your restock order?

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