Date of Request * Choose an Art Kit Which Art Kit would you like to request? You may request up to two kits per week. Please note: We are not available to deliver kits between 4 pm Fridays through 11 am Monday, or on holidays. * Journaling Kit Brain Teaser Kit Coloring Book Kit Playing Cards Kit Watercolor Kit Origami Kit PLEASE SELECT UP TO 2 ART KITS. Patient Information Patient Name * Patient Room Number * Requested by * Relationship to Patient * Phone or Pager * Email Address How did you learn about this service? A Duke Hospital Staff Member let me know I found it listed in the Patient Guide I found it on your website Family member let me know Other Additional Information Please provide any additional information about your needs or how your learned about our services.