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Refer a Child

Local Houstin area Hospital patients who qualify for a Kiss of HOPE® may be referred to our program by a hospital’s social worker.  However, if your child meets the following requirements and is seen at another hospital, please fill out the form below.

  • Aged 0-21 years old
  • Resident of Texas
  • Located in the Houston area and surrounding counties
  • Diagnosed and in a doctor’s care for one of the below brain/spine tumors

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