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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.

WHO CAN REFER A CHILD?

Make-A-Wish accepts referrals from:
  • Children being treated for a life-threatening medical condition
  • Parents or legal guardians
  • Medical professionals (typically a doctor, nurse, social worker or child-life specialist)
  • Family members with detailed knowledge of the child's medical condition

Who is eligible?

A child with a critical illness 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.

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, Southwest Florida Regional 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 505
St Thomas, VI 00802-5819
(340) 474-0798

Make-A-Wish® Southern Florida, Tampa Bay Regional Office
324 North Dale Mabry Hwy
Suite 203
Tampa, FL 33609
(813) 288-2600

Make-A-Wish® Southern Florida, Suncoast Regional Office
3430 Magic Oak Lane
Sarasota, FL 34232
(941) 378-9474