It's My Heart Order Form
It's My Heart is distributed free of charge to parents, loved ones, patients,
health care professionals, and support group leaders.
* Required Fields
Order Information
* Copies of It's My Heart 
* First Name 
* Last Name 
  Company Name 
* Address 
* City 
* State/Province 
* Zip/Postal Code 
  Home Phone 
  Cell Phone 
  Work Phone 
* Email 

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We keep your personal information private and secure. When you make a payment through our site, you provide your name, contact information, payment information, and additional information related to your transaction. We use this information to process your payment and to ensure your payment is correctly credited to your account.

Contact Us: The Children's Heart Foundation•• PO Box 244, Lincolnshire, IL 60069
•• 847-634-6474••

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