Share Referral Inquiry Form

Share the Referral Inquiry Form

Share our online inquiry form with someone who can refer a child who lives in the U. S. or one of its territories. Once a referral is received, Make-A-Wish will work with the child's health care team to determine eligibility.

Make-A-Wish® accepts referrals from: parents or legal guardians, healthcare professionals, children being treated for a critical illness and family members with detailed knowledge of the child's current medical condition.
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