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

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        

Due to the number of wish requests received,
There is approximately a one-year waiting list for wishes to be considered.  
At this time, we are not accepting any new applications.
The Wish Request Application will become available 
when we are able to begin accepting wishes again.
​Thank You.

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 - 7749 Supreme Ave. NW North Canton, OH 44720
   

Required Douments

These Items Are Mandatory Before The Wish Will Be Considered