Return to mobile version

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.

Email to

from

Message

Optional

Type the characters below



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.

You might also be interested in ...

Latest Tweet

  • ⭐Great news alert⭐ Approximately a year ago today wish kid Colt was on his once in a lifetime wish trip! The great… https://t.co/q8oxKm7Rbb
Make-A-Wish® Mississippi
607 Highland Colony Parkway
Suite 100
Ridgeland, MS 39157
(601) 366-9474
Toll Free (800) 819-4072
Make-A-Wish® Mississippi, Southern Region - Gulfport
P. O. Box 7488
Gulfport, MS 39506
(228) 575-8691
Emergency Cellular (601) 214-3472