Refer A Child

Although we receive most of our referrals from parents/guardians and members of the medical community, we also rely on you – residents of Alabama communities who know a child in need of a magic moment. All information we receive concerning the child is kept confidential.

If you would like to refer a child, please fill out the form below. If the child meets our criteria, we will contact the family and begin the application process.

If you prefer to speak with someone directly, contact our Statewide Magic Moment Coordinator at 205.777.5741 or email [email protected].