Get a Monkey

Please fill in the form below to register to have your child receive a monkey pack. After confirming the information and that the criteria have been met, you will receive a monkey pack in the mail and an email providing you online login information.

Only children who are battling cancer are eligible to receive a free Monkey In My Chair kit. We reserve the right to seek approval of the request from the attending physician and may refrain from fulfilling requests we feel are Illegitimate. Due to the mass number of kit requests we receive, if we are unable to fulfill all requests immediately a request will be placed on a waiting list. Illegitimate requests keep us from being able to send kits to children on this list, those who truly deserve them, and may hinder our ability to maintain sending kits at no cost. Because of this, we ask that you only request a kit if your situation meets our requirements, and if you feel your child truly will benefit from our program. Unfortunately, we do have individuals seek kits that do not actually need them for their intended use. It is because of this that we research the information you provide, making it important you provide us with as much information as possible. Thank you for your understanding. Unfortunately, if you do not meet the requirements we do offer kits to be purchased here.

Note: All hospitals should click here to request their kits.
If you already received your kit at your hospital, please register it here.

Fields with * are required.

Parent's Information


If you are not the legal guardian, please contact us prior to filling out the form.



Shipping Information


Child's Information

(i.e. CaringBridge, Care Pages, Facebook)


Additional Information

Please setup a hero page to allow others donate in our child’s honor for the Monkey in My Chair program and for cancer research. Learn more.

I have read and agree with the HIPAA terms located at http://www.monkeyinmychair.org/hipaa and attest that I am the legal guardian of the applicant for the program.