330-244-WISH  info@grantedwish.org 
7749 Supreme Ave. NW | North Canton, OH 44220

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:  wishes@grantedwish.org  (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
   

Online Wish Application