Wish Referral

Refer a Child to Have His or Her Wish Granted

To refer a child, please fill out & submit the form below or download the form and email it to Info@achildswish.org.

WHO IS ELIGIBLE?

A Child’s Wish of Louisiana has helped thousands of critically-ill Louisiana children’s wishes come true! Children between the ages of 2 – 18 years old who live in Louisiana and have been diagnosed with a critical illness – meaning a progressive, malignant or degenerative condition that places the child’s life in jeopardy – are eligible to receive a wish from our organization. The child should not have already received a wish from any other wish-granting organization.

WHO CAN REFER A CHILD?

Our mission is to reach as many Louisiana children as we can and the first step is having someone who cares tell us about a child who needs our help. We accept referrals from a child’s parent / guardian; from the child’s healthcare provider, including physician, nurse or nurse practitioner, or physician’s assistant; from social workers; or from a friend or family member with a detailed knowledge of the child’s medical condition.

Please note that the completed referral form is NOT an official application, but it is rather request for that child’s family to be contacted and receive additional information.

Wish Candidate Referral

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