We often are asked about changing the diagnosis or title for a design that someone loves and we now offer this as an option. To place a custom order you may go to the custom order collection tab and any items listed there can have the diagnosis or title (ex autism mom) changed. However the font and overall design of the item will remain the same just the minor changes are allowed. Once you have selected the item you wish to make custom you will write in the notes section of the order the diagnosis and/or title change. Before a custom order is made we will send an email with final approval before processing starts. We do not offer size exchanges or refunds for custom orders. If you are confused or unsure of how to place a custom order you can email us at email@example.com .