ANYONE may refer a child to us.
(Their Mother, Father, Doctor, Teacher, Relative, Friend, etc.)
The Child MUST reside in the Fairfield, Litchfield or New Haven Counties of Connecticut.
All referrals MUST
be in writing or via the online form below.
Once the form is completed, intake and authorization forms will be mailed to the Parent(s) / Guardian(s).
This form explains our mission, requests additional information,
as well as include a request for the names of TWO of the child’s attending physicians,
for verification and qualification purposes.
Before completing the form,
please review our Policies and Guidelines
below.
PLEASE NOTE:
A child MUST be deemed eligible BEFORE being granted a Dream.
Eligibility will depend on verification by their physicians,
as well as final approval by our Board of Directors.