Refer a Child

Help us bring magic to a child who needs it most

Do you know a child who could benefit from a moment of hope?
You can help us reach them.

A referral is often the first step toward giving a child joy, comfort, and a memory their family will treasure forever. Whether you’re a parent, caregiver, healthcare provider, social worker, or community partner—your referral can open the door to something truly magical.

Who can refer a child?

We welcome referrals from:

Parents and legal guardians
Healthcare professionals (nurses, doctors, therapists, care coordinators)
Social workers and case managers
Teachers, counselors, and community leaders
Family members or friends (with guardian approval)

If you know a child who could use a spark of magic during a challenging time, we want to hear from you.

Who we serve

Macie’s Foundation grants wishes to medically fragile, critically ill, or economically disadvantaged children who need joy, hope, and moments of magic. We are committed to serving children who may be overlooked by other programs—including those facing both medical challenges and financial hardship.

If you’re unsure whether a child qualifies, you can still refer them. Our team will help determine eligibility with compassion and care.

Referrer's Information

(Person submitting this form)

First name

Last name

Relationship to Child

Organization name (if applicable)

Phone

Child's Information

(The child you are referring)

First name

Last name

Birthday

Month

Day

Year

Gender

Multi-line address

Country/Region

Address

Address - line 2

City

Zip / Postal code

Primary Language

If the child has a diagnosis or medical condition, please share information about this below. Please be sure to include the child's primary diagnosis, the treating hospital or clinic, and the name of the primary care physician or specialist.

If the child does not have a medical condition or diagnosis and is being referred due to financial hardship, you may state that above or leave blank.

Why do you believe this child should receive a wish?

Does the child have a wish or interest you are aware of? If not, does the child need a piece of equipment such as a wheelchair, stander, or other piece of equipment to improve their quality of life?

File upload

In some cases, families in need of special durable medical equipment may receive a quote from providers. If you are in need of something specific and have received a quote, please upload the file above.

Permission & Consent

I confirm that I have the child’s parent or legal guardian’s permission to submit this referral.

I understand that Macie’s Foundation may contact the child’s parent/guardian to verify eligibility and discuss wish opportunities.