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.
In the comments/question section of this form, please indicate your child’s life-threatening medical condition/diagnosis
Please keep in mind that Make-A-Wish® does not cold call families of potentially eligible children. We ask you to please exercise compassion and suggest to families that they contact Make-A-Wish directly.
A second-party introduction can be unsettling for a child or the family. We prefer that the referral process be as comfortable, inspiring and private as possible.
Thank you for your consideration in this regard.
Please feel free to call us at 312.602.9474 (800.978.9474, toll-free) with any questions you may have.
Formulario de Recomendación en Español. Imprimir y fax al 312.602.9499 o por correo electrónico. Llame 312.602.9446 con preguntas.
Descargar el formulario (PDF)
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Office Phone Numbers
Chicago - 312.602.9474
Peoria - 309.637.1659
Springfield - 217.544.9470
Toll-Free - 800.978.9474
Sí, hablamos español.