CHECKLIST TO ACCOMPANY YOUR MICROBEAD BREAST FORM ORDER:

To provide you with the best fit, please answer the following checklist. This will tell me what customizations you may need. There is no additional charge for any customizations. You will receive two forms, each the same size and shape, so they can be worn on either left or right side, and each will be customized in the same way if it's needed. I will offer tips in parenthesis to help you choose, stating what most choose in your situation.

Which microbead breast form shape do you want?



What color do you prefer?




What size microbead forms would you like to fit your specific bra size?














Which of the following best describes you?





Some with a single mastectomy like for their forms to have additional weight for balance by adding polybeads (larger and heavier than microbeads) in with the microbeads. You can choose to have this weighting mixture added whether you have had a single or double mastectomy.

Do you want your forms with microbeads alone or a slightly weighted mixture?



If you are trying to match the size and drape of a natural breast remaining on the other side that may have begun to relax a bit with age, it's helpful to be able to relax the perkiness of your new breast form to match it. I can sew your form with an ADJUSTMENT TUBE extending out from the seam, then fold it down and safety-pin it shut after filling the form. You will be able to easily squeeze out some filling, then either sew across the tube by hand or just leave it safety-pinned shut to use again for future adjustments. There is a simple photo tutorial on this website to show you how to sew the tube closed, it's on the same page where you buy the forms. There is another tutorial that shows how to still remove some beads even if you didn't order the Adjustment Tubes added.

Would you like for this tube to be provided on your breast forms for expected adjustments?



If your chest wall isn't very flat and you need to fit in behind your breast form, I can eliminate most of the thicker lining at the center back of the form, so that it can expand forward. This is especially helpful when reconstruction has failed or implants were removed, leaving significant bumps or ridges.

Do you want me to change the back of your breast forms to allow your shape to fit more easily into the back of the microbead forms? If you choose "Yes", you should also choose "Yes" in the section above to add the fabric tube for adjusting the filling.



As soon as I receive this checklist and your PayPal payment of $42, I will take a copy of this form to my sewing room and put your order in line so that I can begin making your forms to order. I'll email you as soon as they are finished and mailed, giving you a projected date of arrival there. If you live within the United states, the payment of $42 covers your shipping, too. BUT...If you live outside the United States, you will have to pay additional postage, and will need to submit this checklist for me to estimate the weight of your finished customized forms before sending you your total cost.

Will this package be shipped to an address inside the United States?



That's all I need to know to begin making your new microbead breast forms. The information you send to me here will ONLY be used to complete your order, it will never be given or sold to anyone. To SUBMIT this form, please first type in the 'Captcha' word or numbers below, and hit the Submit button afterward, making sure that on the next screen it says your order successfully submitted. If it's too hard to read the code below, you can keep clicking the 'reload' button (looks like two arrows going in a circle at the top, above the speaker icon) next to the Captcha insignia, until one comes up that's easier to figure out. Thank you for your patience. If you don't hear from me withing 24 hours that I've received your order, you may have missed hitting the Submit button and need to fill it out again, so please pay close attention to completing this action below to submit it..