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Flower Request Form
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TENNESSEE ONLY
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By requesting a care package or flowers through Breast Connect, you hereby release and agree to indemnify and hold harmless Breast Connect, Inc. and its members, officers, directors, employees, and agents from and against any and all claims, liabilities, and damages arising from the products you receive or out of the sharing or storage of any information you provide to us and from the interactions with persons with whom you connect through Breast Connect, Inc.

Breast Connect, Inc. has not been established to sell healthcare products, drive opinions, or be a persuasive source. By submitting a request to receive a Breast Connect Heart-to-Heart Care Package, you are authorizing Breast Connect, Inc. to store your information in a database. Your information will not be shared outside of Breast Connect without your written consent. 

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