This inquiry form is the first step to receiving a wish – it is not confirmation of eligibility for a wish. Your information will be forwarded and you will be contacted by a member of our wish-granting team.
We value your privacy and will not share your personal information.
Please confirm your email address. We want to make sure we can respond to your request.
Medical professionals, parents, legal guardians and potential wish kids can initiate the referral process.
Find out how to refer a child if you don't fit this criteria, or if the child lives outside of the United States and its territories.
A child with a life-threatening medical condition who has reached the age of 2½ and is younger than 18 at the time of referral is potentially eligible for a wish.
Read more on eligibility criteria for a potential wish child.
(714) 573-WISH (9474)