Use our online Referral Form

Referral Form

Do you know a child or young person who is suffering from a life threatening illness?

You can refer a child or young person for a wish with us today by filling out the referral form below.

Unsure whether they are eligible for a wish with us? Give Cathy our Wish Coordinator a call on 01202 514515.

Please note all referrals that we receive are treated in the strictest confidence.

 

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To the best of your knowledge:


We like to keep in touch with our referrers and send information on developments within Round Table Children’s Wish. If you do not wish to be contacted in future please tick the box. NOTE: At no time will we pass your information to other organisations.


 

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