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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® Texas Gulf Coast & Louisiana
12625 Southwest Freeway
Stafford, TX 77477
(281) 491-9474

Make-A-Wish® Texas Gulf Coast & Louisiana, Louisiana Office
3340 Severn Avenue
Suite 350
Metairie, LA 70002
(504) 846-9474
Toll Free (888) 677-9474