Refer a Child

“If you could wish for anything . . .what would it be?”

Wish granting starts with one question — a wonderful and magical question that indulges the imagination and empowers the spirit. The answer can be as simple as a new puppy or as complicated as touring the Ferrari factory in Italy. The Make-A-Wish^® staff, along with more than 350 caring, trained volunteers, use creativity and the generosity of others to fulfill each wish.

Make-A-Wish follows certain policies and guidelines to ensure the child’s health and safety. Likewise, the child’s physician and parents are consulted to ensure the best possible experience. Wishes are granted without regard to race, gender, creed, socio-economic or cultural background.

First Name:
Last Name:
Relationship to Child:	Select Relationship Self Parent/Legal Guardian Medical Professional
Email Address:
Phone Number:
Street Address 1:
Street Address 2:
City:
State:
Zip Code:
Comments or Questions:

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