Written by a parent, not a doctor. Nothing here is medical advice.

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Cool Kids Campaign

Birthday and Smile Boxes

What you get

Free birthday and smile boxes when you register with Cool Kids. Ask whether requests are open.

Who starts it
You, with a document from your doctor
How it’s sent
Email to danielle@coolkidscampaign.org, or by post
Your time
An hour or so, plus waiting for the document
Last checked
Aug 27, 2026

Before you start, check you fit

  • The hospital confirms diagnosis and treatment on the registration form.

  1. Ask your doctor for the documentStart here. This is the part that takes the longest.

    Cool Kids Campaign needs a signed confirmation of the diagnosis from your doctor. Copy this message, or say it in person at the next visit.

    Hi [doctor’s name],

We’d like to apply to Cool Kids Campaign’s Birthday and Smile Boxes. They offer free birthday and smile boxes when us register with Cool Kids, and we are checking whether they are taking requests.

They need a signed confirmation of the diagnosis from you. Their form and instructions are here: https://coolkidscampaign.org/become-a-cool-kid/

Could you do that when you have a chance? I’ll bring the printed form to our next visit, or I can email it. Thank you for everything you do for us.

[your name] · [phone]
    Copying is the only thing this page does with your text. Nothing is saved.

  2. Fill in their formPrint it, or fill it in on screen if the PDF allows.

    Open the application PDF ↗ Checked Aug 27, 2026

    What the form asks for

    Program selection
    I am interested in
    Parent or guardian and household information
    Referred to Cool Kids byChild’s Full NameDate of BirthAgeGenderHome Address / City / State / Zip CodePreferred Language(s)Parent/Legal Guardian Name / Phone / EmailSecond Parent/Legal Guardian Name / Phone / EmailNames and ages of other children living at home
    Care package preferences
    Name I prefer to be calledFavorite colorQuiet activityGaming systemActive activityBand / artistTV show / channelRestaurantMovie categorySports teamSport to play/watchClothing sizeStoreIf I could spend my time doing anything it would be
    Medical assessment · your care team fills this in
    Hospital NameHealthcare professional name/titleHealthcare professional email and phone numberType of cancerDate of diagnosisIs this child undergoing treatmentIf not, last date of treatmentHow often is the child seen by hospital staffCurrent treatmentI verify that this patient is in treatment at (name of hospital)Healthcare professional signature & date
    Liability release and authorization
    I grant / I deny permission to use my child’s name and image in promotional materialsParent/Guardian signature and dateSecond Parent/Guardian signature and date (if child has two parents or legal guardians)

    Have ready

    • Completed Cool Kids family application, including parent release and publicity choice.

  3. Email your application and the document togetherTo danielle@coolkidscampaign.org. Or post it to the address on the form.

    • Return the completed official PDF by email to danielle@coolkidscampaign.org, by fax to 410-560-1775, or by mail to 8422 Bellona Lane, Suite 102, Towson, MD 21204.

    Email: danielle@coolkidscampaign.org

    Fax: 410-560-1775

    Subject: Birthday and Smile Boxes application, [child’s name]

Hello,

Attached are our completed application and the document from [doctor’s name] at [hospital]. Please let me know that it arrived and if anything is missing.

Thank you,
[your name] · [phone]

After you send

Contact the regional program office to confirm receipt and ask about current program-specific availability. If you have not heard back in two weeks, write and ask whether it arrived.

Full record, as published