The Marty Lyons Foundation (MLF) grants wishes to children, ages 3-17, who have been diagnosed with a terminal or life threatening disease. Families or social workers interested in submitting an application for a wish from the Marty Lyons Foundation must first ensure that the child meets our eligibility requirements.

ELIGIBILITY:

1).  Child must reside or receive medical treatment within the Foundation’s designated geographic locations:

• Alabama
• California
• Connecticut
• Connecticut
• Florida
• Georgia
• Maryland
• Massachusetts
• New Jersey
• New York
• North Carolina
• Pennsylvania
• South Carolina
• Texas
• Virginia

2).  The Marty Lyons Foundation is primarily accepting applications for first wish requests.  A wish is considered a first wish request if the child has not received or is not in the process of receiving a wish from any other organization. – Second wish requests (regardless of the original granting Foundation) are only granted under exceptional medical circumstances and typically considered after 2 years from the time of the child’s first wish. – At this time, these 2nd wish requests are subject to a waiting list.    – To be added to the list for future consideration, please email Krystal Monroy, our Director of Mission Delivery, by CLICKING HERE.

INSTRUCTIONS:

• Four (4) forms are required:
  • Parent’s – To be completed by the child’s parents
  • Physician’s  – To be completed by the child’s doctor
  • Release & Indemnification – To be completed by the child’s parents and notarized
  • Authorization to Release Protected Healthcare Information – To be obtained directly from the child’s medical facility and completed by the child’s parents
• Upon completion, all four (4) forms are to be mailed to MLF’s headquarters
  • The Marty Lyons Foundation, 105 Sweeneydale Avenue, Bay Shore, NY, 11706

Downloadable Application Files:

• Application Instructions
• Parent Application Form
• Physician Information Form
• Release and Indemnification Form