Referral Inquiry Form

This form is the first step of the wish process.  It is not confirmation of eligibility for a wish. Your information will be forwarded to your local Make-A-Wish^® chapter and you will be contacted by a member of our wish-granting team. You can also share our online inquiry form with someone who can refer a child who lives in the United States or one of its territories.
_{Please note: We recommend completing the form using an updated web browser, such as Google Chrome or Microsoft Edge, for an optimized experience.}