Written by a parent, not a doctor. Nothing here is medical advice.

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Marty Lyons Foundation

First Wish Program

What you get

An approved wish arranged for your child, with payment made directly to the providers. Open now.

Who starts it
You, with their part of the form from your doctor
How it’s sent
By post
Your time
About 30 minutes, plus waiting for the form
Last checked
Aug 27, 2026

Before you start, check you fit

  • Your child is between 3 and 17.
  • A case closes if complete original forms are not received within 60 days; reapplication is then required.
  • All adults 18+ participating sign releases; sibling coverage changes at 18.

  1. Ask your doctor for their part of the formStart here. This is the part that takes the longest.

    Marty Lyons Foundation needs 2 things from your doctor. Copy this message, or say it in person at the next visit.

    Hi [doctor’s name],

We’d like to apply to Marty Lyons Foundation’s First Wish Program. They offer an approved wish arranged for our child, with payment made directly to the providers, and they are taking applications now.

They need 2 things from you: a signed confirmation of the diagnosis and a signed medical form. Their form and instructions are here: https://martylyonsfoundation.org/about-us/faqs/

Could you do that when you have a chance? I can send you the link, or bring a printout to our next visit. Thank you for everything you do for us.

[your name] · [phone]
    Copying is the only thing this page does with your text. Nothing is saved.

  2. Fill in their applicationIt is on their website.

    Open their application ↗ Checked Aug 27, 2026

    What the form asks for

    Parents Application Form
    Child’s NameBirthdateSexAddress / City / State / ZipParent/Guardian’s Name / Home or Cell Phone / Address / Email / Best time and place to callName(s), dates of birth and relationship of other family childrenHospital / AddressPhysician / PhoneSocial Worker / Phone / Social Worker CommentsHow did you hear about our FoundationHas applicant ever applied for and/or received a wish from any not-for-profit organization including the Marty Lyons Foundation? If yes, please detail: Agency / Wish / Date of wishChild’s ‘Special Wish’ (Be specific)Parent/Guardian CommentParent/Guardian Signature / Date
    Physician Information Form · your care team fills this in
    Child’s Name / Date of Birth / AddressDiagnosis / Date of DiagnosisCurrent TreatmentPrognosisCommentsAre you aware of Child’s ‘Special Wish’If the request is for a trip, when may child travel? Any pandemic related RestrictionsDoes child require any special apparatus (e.g. wheelchair)Attending Physician’s Name / Hospital / Telephone / AddressPhysician’s Signature / Date

    Have ready

    • Completed, signed original Parents Application Form.
    • Original Release and Indemnification Form signed by required adults and notarized.

  3. Post your application and their part of the form togetherTo the address on the form.

    • Mail all four completed original forms to The Marty Lyons Foundation, 105 Sweeneydale Avenue, Bay Shore, NY 11706, within 60 days of the first received application document.

After you send

Call 631-543-9474 or use the current wish-question email link on the official application page if clarification or receipt follow-up is needed. If you have not heard back in two weeks, write and ask whether it arrived.

Full record, as published