Refer a Family

Referral Forms

We have two different referral forms for those interested in referring a family or child to us. The first is the form for partners of Santa’s Helpers, Inc., which includes social workers, referring agency administrators, school officials and hospital professionals. Forms submitted by individuals who are not affiliated with a professional organization that Santa’s Helpers partners with will not be accepted. The second form is for those contacting Santa’s Helpers on behalf of a hospital organization. If you have any questions about the referral forms, please contact us.

Please Select the Appropriate Form Below

  • * Required for Toys
  • (If living in home)
  • (If living in home)
  • Child's NameGenderAgeClothing Size 
  • This field is for validation purposes and should be left unchanged.