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Referral Inquiry Form

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.

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We value your privacy and will not share your personal information.

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Please confirm your email address. We want to make sure we can respond to your request.

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Make-A-Wish® Southern Florida, Inc.
4491 S State Road 7
Suite 201
Ft. Lauderdale, FL 33314
(954) 967-9474
Toll Free (888) 773-9474
Make-A-Wish® Southern Florida, West Coast Field Office
3655 Bonita Beach Road
Suite 3
Bonita Springs, FL 34134
(239) 992-9474

Make-A-Wish® U.S. Virgin Islands
PMB 547
8168 Crown Bay Marina Ste 310
St Thomas, VI 00802-5819
(340) 513-8213