Enriching the lives of children battling serious illness & injury...

VIP Programs

During these tough times, normal recreational activities quickly give way to a mind-numbing series of doctor visits and treatments. Several times a year, Hope’s Haven sponsors special VIP events, tailored especially for children in treatment, so they and their families – including brothers and sisters — can put their illness on the back burner for a while and just have some fun together.

    Referring Party:

  • Name:
  • Phone:
  • Email:
  • Relationship:

    Patient Information:

  • First Name:
  • Last Name:
  • Age:
  • Address:
  • City:
  • Zip Code:
  • Phone:
  • Email:
  • Mother/Father/Family Contact / Name:
  • Language Preference:
  • Hospital:
  • Diagnosis:
  • Date of Diagnosis:
  • Attending Physician:
  • Social Worker:

    Financial Assistance:

  • Household Income:
  • Is the Parent/Guardian on unpaid leave:
  • How many people are in the household:
  • Ethnicity(Optional):
    • VIP Events:

    • Would your Child be interested in being apart of a VIP event where he/she will be invited to special events such as Dodger Games, Naval Base Visits, or Holiday Parties?: