To Refer A Child… 

If you have a child you wish to refer to us for medical treatment, please complete and submit to us the following information listed below. We only accept children with serious medical conditions that can be corrected with surgery. We are unable accept children with chronic conditions, with cancer, or in need of a transplant.

Please provide the following information:

• Your Name and Contact information
  Be sure to include your name, mailing address and phone number, and if available, a fax and email address that we can contract you at.
• Your Child’s Name and a Photo
• A Photo of Your Home
• A Photo of Your Family
• Social History Form
• Medical History Form
• Power of Attorney
• Your Child’s Medical Records (Physician reports, x-rays, MRIs, blood work, etc…)

Please complete all information and mail to:

Mending Kids International
P.O Box 1007
Santa Clarita, CA 91386
Phone: 661-298-8000
Fax: 661-298-8833
Email: info@mendingkids.org

Please note that submission of your application does not guarantee medical treatment.