This puzzle piece awareness ribbon charm necklace comprised of a 12.5mm sterling silver disk manually engraved with an initial of your choice. Paired with a 19mm enameled sterling silver awareness ribbon. Choice of sterling silver length of chain. Disks are punched into charms, polished to shine and engraved at time of order. Engraving done via a diamond drag engraving tip, not to be mistaken for hand stamping. Handmade in Canada.