Refer a Child

Children’s Wish Foundation International prides itself on providing quality, creative, and carefully researched wishes to children all over the world.

To Qualify

  • The child must be under the age of 18 at the time of the application.
  • The child must have been diagnosed with a life-threatening illness.
  • The child must not have received, or be in the process of receiving a wish.

Children’s Wish Foundation accepts referrals from:

  • Parents or legal guardians
  • Healthcare professionals
  • Children being treated for a life-threatening medical condition
  • Other family members

How to refer:

You can refer a child online by completing the below application.
You can also call us toll-free at 1-800-323-WISH (9474)

Referral Form

  • Child's Personal Information

  • MM slash DD slash YYYY
  • Parent / Guardian Information

  • Your Relationship to Child

    As the person referring this child, please provide the following information should we have a need to contact you.
  • Hospital and Primary Care Information

  • Contact Information

  • This typed signature certifies that the facts contained in this form are true and accurate to the best of my knowledge.