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STITCHES Information Form
STITCHES Womens Iniaitives 28056 Palomino Drive Warren, MI 48093  Phone: 586-873-8034
Inf o r m atio n  For m  
Stitch es W o m en ’s  I n itiativ es
TH IS   D A TA IS P U T   O N   O U R W E BSITE
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   R ace/ethnicity : ________________________________________   C h eck t h e item  t h at a p p li es the  type of  doll you have created:       _____  Stitches Doll Project  HIV/AIDS   Please include date of diagnosis:   _______________________   _____  ClotNot Project  Bleeding Disorders   Please include date of diagnosis:   _______________________   _____  Transitions Project Ge nder Issues   _____  Youth@Risk Project -  Youth Issues   _____  Victory Against Violence Project     Abuse Issues
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