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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?

Medical professionals, parents, legal guardians and potential wish kids can initiate the referral process.

Find out how to refer a child if you don't fit this criteria, or if the child lives outside of the United States and its terroritories.  

Who is eligible?

A child with a life-threatening medical condition 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.

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Make-A-Wish® East Tennessee
6005 Century Oaks Drive, Suite 500
Chattanooga, TN 37416
(423) 629-9474