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How to Request a Wish

To help make your wish come true, we need a few things to get started. We ask that you take the following steps:

• Write a paragraph explaining your wish.

• Complete the Request Form (see pdf below).

• Have your physician or medical care provider complete the Physician Statement (see pdf below).

• Include a photo of yourself (optional).
   

Once you have completed the four steps and send the packet to,

An Elderly Wish Foundation
P.O. Box 4365
Antioch, California 94531-4365

The Board of Directors will verify your eligibility, contact you with any questions, and get started on your wish.