Referrals

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The Children's Dream Fund is ready to help every child, age 3-18, living in West Central Florida, who is referred to us for a dream-come-true. The Children's Dream Fund keeps all information received strictly confidential, and takes pride in making the dream process as stress-free as possible for our families.

We determine a child’s medical eligibility with the help of the treating physician. Referrals are received from seven area hospitals, including Shands (Gainesville), Tampa Children’s Hospital at St. Joseph’s, University Community Hospital (Tampa), Tampa General Hospital and All Children’s (St. Petersburg). These referrals are received from doctors, nurses, Child Life and Social Workers, friends, families and other patients. Following the receipt of an application and verification of diagnosis, the children are interviewed by a Dream Fund staff member.

Application forms are available by contacting one of our dream coordinators or by filling in our referral form. If you are in the medical or healthcare industry, you may access our Medical Staff Referral secure page to download applications, releases, etc. and/or to complete a referral form directly online. To obtain access, please contact our dream coordinators.

Referral Form


First Name *
Last Name *
Your Email *
Your Phone Number *
Child's First Name *
Child's Last Name *
Child's Age *
Child's Illness *
Relationship to Child *
Child's Parent's Full Name *
Child's Parent's Full Name *
Child's Parent's Phone # *
Child's Address *
City *
State *
Zip Code *
Comments
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