Request Card(s)

Refer a Child to Receive a Card from CFHK

In addition to distributing cards in hospitals, CFHK also sends cards to individual kids, facing health issues, who are referred to us via our form below. The child can be referred by a parent, family member, healthcare provider, family friend, etc. All information sent to CFHK will remain confidential. Many of the kids referred go on to receive cards from CFHK regularly. Once the child is referred, a card will be sent to them within a few days. If you have any questions, please contact us via the contact form.

* Indicates required field

Your Name *

First

Last

Email Address *

Phone Number *

Relationship to the Child *

Name of the Child *

Age of the Child *

Details on the Child's Health Condition(s) *

Does the child have any favorite colors, characters, sports, etc we should be aware of in selecting cards? *

Mailing Address for the Child *

Line 1

Line 2

City

State

Zip Code

Country

Are there any other details you'd like us to know? *

Submit