Remember To Download And Print The
Medical Authorization Form
Please note that EVERY FIELD requires an answer in order to click the Submit Button. If a question does not pertain to you, be sure to state N/A in the field.
If all of the fields are completed properly, the "Submit Button" will be highlighted.
REMINDER OF HOW TO SUBMIT YOUR REQUIRED MEDICAL AUTHORIZATION FORM & NOMINEE'S PHOTO:
1. EMAIL: email@example.com (Scan Form must be in a .PDF Format - Photo in a .JPG Format)
2. POSTAL MAIL: The Granted Wish Foundation - 7749 Supreme Ave. NW North Canton, OH 44720