Medical Outreach Toolkit
Medical Outreach Toolkit
Make-A-Wish® International
Make-A-Wish® International
Embedded Files
Current Forms
Current Forms
In order to confirm the eligibility of the referred child, we need various forms to be completed.
DOWNLOADABLE DOCUMENTS
DOWNLOADABLE DOCUMENTS
The Wish Referral Form
The Wish Referral Form
This form is provided to the medical professionals to refer a child.
Wish Referral Form.pdf
The Medical Eligibility Form
The Medical Eligibility Form
This form is necessary in order to confirm the medical condition of the referred child.
Medical Eligibility Form.pdf
The Wish Authorization Form
The Wish Authorization Form
Through this form, the doctor is informed of, and approves, his/her patient’s wish from a medical perspective.
Wish Authorization Form.pdf
The Parents Form
The Parents Form
This form combines the previous three forms, i.e. medical disclosure, publicity and liability release.
Parents Form.pdf
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