YOU MUST ALSO COMPLETE & SUBMIT THE MANDATORY REQUIRED
MEDICAL AUTHORIZATION FORM & PHOTO OF THE NOMINEE
BEFORE YOUR WISH WILL BE CONSIDERED

If you meet the Eligibility and Guideline Requirements, ​you can complete the Online Wish Application 
​Or print a Hard Copy of the Application by clicking one of the links at the bottom of this page. 
​If you print the Application, you can scan and email it or send it through Postal Mail.

HOW TO SUBMIT REQUIRED MEDICAL AUTHORIZATION FORM & NOMINEE'S PHOTO:

     1.  EMAIL: wishes@grantedwish.org  (Scan the Form - must be in a .PDF  Format - Photo in a .JPG Format)
     2.  POSTAL MAIL: The Granted Wish Foundation - c/o 604 35th St. NW Canton, OH 44709    

​                                        330-244-WISH  info@grantedwish.org 
c/o 604 35th St. NW | Canton, OH 44709

REQUIRED MEDICAL AUTHORIZATION FORM & NOMINEE'S PHOTO:

    1.  Medical Authorization Form:  (You must Download and Print the Form below)
 
               a)  Click on the "Medical Authorization Form" button below to download and print the Form
               b)  This Form must be completed by the Nominee's Treating Physician
                  
     2.  A Photo Of The Nominee:
              a)  It is preferred that a color photo is sent via email. If sending via postal mail, please send a color, clear photo
              b) You are welcome to send more than one photo 

​Eligibility, Required Documents & Wish Application

DISABILITIES & DISORDERS THAT DO NOT FALL WIthIN OUR CRITERIA INCLUDE:

     1.  Autism and Autism Spectrum Disorder                                                                                                
     2.  Asperger Syndrome
     3.  Diabetes
     4.  Asthma                                                                   
     5.  Bipolar Disorder      
     6.  Depression Disorders                                                                 
     7.  Psychological Disorders  
     8.  Learning Disabilities or Behavioral Issues                                            
     9.  ADHD/ADD
   10.  Anxiety Disorders
   11.  Eating Disorders
   12.  Alcohol & Substance Abuse/Dependence
 
   Please Note:  This list is an example and no way indicative of every potential intellectual disability or disorder. Any applications that
   are submitted that fall into these types of categories will be evaluated for eligibility.  

eligibility Requirements:

     1.  The Nominee must be between the ages of 5 - 25 at the time the application is submitted and a resident of the United States
     2.  The Nominee must be diagnosed with a physical challenge by a physician
     3.  ​The Nominee must be 18 to nominate themselves  
     4.  Intellectual Disabilities and certiain disorders do not fall within our criteria of what we accept as physically challenged (See List Below) 
     5.  Wish requests must directly benefit and enrich the life of the physically challenged nominee
     6.  Wish applications may only contain one wish request for the nominee
     7.  The requester must specify the exact sports wish for the nominee; our organization does not choose the wish    
     8.  The required Medical Authorization Form and the Nominee's Photo must be received before qualified wish requests will be considered
     9.  The Nominee may not have received a wish by another wish granting organization at any time
   10.  The Nominee or family of the nominee, may not have had a prior wish request submitted to our organization, whether granted or not