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Share the Referral Inquiry Form

Share our online inquiry form with someone who can refer a child who lives in the United States or one of its territories.

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Make-A-Wish accepts referrals from:

  • Parents or legal guardians
  • Healthcare professionals
  • Children being treated for a critical illness
  • Family members with detailed knowledge of the child's current medical condition


Do you know someone who can initiate a referral inquiry on behalf of a deserving child?


Share our Referral Inquiry form with them.
Make-A-Wish® Philadelphia, Delaware & Susquehanna Valley
5 Valley Sq, Suite 210
Blue Bell, PA 19422
(215) 654-9355

Make-A-Wish® Philadelphia, Delaware & Susquehanna Valley, Susquehanna Valley Office
1054 New Holland Avenue
Lancaster, PA 17601
(717) 283-4880

Make-A-Wish® Philadelphia, Delaware & Susquehanna Valley, Delaware Office
100 W. 10th Street, Suite 106
Wilmington, DE 19801
(302) 482-4467