Apply for a Wish

How to Apply for a Wish

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

• The Marty Lyons Foundation (MLF) grants wishes to children, ages 3-17, who have been diagnosed with a terminal or life threatening disease.
• Child must reside or receive medical treatment within the Foundation’s designated geographic locations:
  • Alabama
  • Connecticut
  • Florida
  • Georgia
  • Maryland
  • Massachusetts
  • New Jersey
  • New York
  • North Carolina
  • Pennsylvania
  • South Carolina
  • Texas
  • Virginia
• 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 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