Disclaimer: 100% of all donations directly support the children. No funds are used for overhead costs.
Important Note
To submit a referral, you will need to provide the following: child and parent/legal guardian’s contact information, child’s date of birth and medical condition(s), as well as the treating medical professional's full name, phone number and hospital treatment facility. Unfortunately, we cannot accept a referral without this information.
Family
Use this form if you are the child’s parent/legal guardian, the child, or a family member who has detailed knowledge of the child’s current medical condition(s).
Refer a child nowMedical Team
Use this form if you are a member of the child’s healthcare team such as a physician, physician assistant, nurse, nurse practitioner, social worker, or child life specialist.
Refer a child nowOther
If you are not a family member or part of the child's healthcare team as described, we invite you to share information about A Child’s Wish with the family.