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FRIEND / NEIGHBOR / TEACHER / ETC.
A non-immediate family member
(friend, neighbor) should give the REFERRAL FORM to the family to complete, or
may complete the REFERRAL FORM on the family's behalf.
Wishes & More
requires that the potential wish family be made aware that a wish request is
being submitted.
The Director of Wish Services
will send a MEDICAL ELIGIBILITY FORM to the doctor. The doctor will
evaluate the eligibility and return the form to
Wishes & More . If the
recipient is eligible, the complete APPLICATION FORM will be sent to the
family. If the recipient is not eligible, a phone call will be made
to the family along with a follow up letter sent stating the recipient is not
eligible at this time.
When the completed wish APPLICATION FORM has been returned to
Wishes & More,
the family will be contacted by the Director of Wish Services.
The completed form should be
returned to
Wishes & More
by fax or regular mail.
To get the
printable form,

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