Please complete this form request custom embroidery, logo placement, or branding services. This information allows our team to accurately prepare your proof and production.

Full Name

Business / Organization Name

Phone Number *

Email Address *

Brand / Style Name or Item Description (if known)

Quantity Per Item

(Example: 25 scrubs tops, 25 scrub bottoms)

Type of Branding Requested

Embroidery

Heat Press / Vinyl

Screen Print

Unsure - please advise

Logo / Design Upload

(Accepted formats: PNG, JPG, PDF, SVG — high resolution preferred)

Thread / Ink Color Preference

If unsure, our team will recommend best options)

Name or Title to Be Added (if applicable)

(Example: "RN", "Manager", first name)

Fone Style Preference

Block

Script

Modern

No Preference

Would you like a digital proof before production begins?

Yes (recommended)

No

Requested Completion Date

(Rush fees may apply)

Anything else we should know?

(Special requests, placement notes, or questions)

I understand that all custom-branding items are final sale once approved and produced.

Yes, i acknowledge

Digital Signature

Clear

Date Signature Please

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