Apply For Care
Children are eligible for care up to the age of 18 if, in the opinion of our physicians, there is a reasonable possibility they can benefit from the specialized services available. Applicants are accepted based solely on a child’s medical needs.
Physician Referrals to Shriners Hospitals for Children® — Los Angeles
Referring physicians should call 213-368-3366 between the hours of 8 a.m. and 4:30 p.m., Monday through Friday to refer patients to the hospital.
Application Procedures for Orthopaedic Care, Spinal Cord Rehabilitation, Cleft Lip and Palate Repair and Non-Emergency Burn Care
The service area of Shriners Hospitals for Children includes the United States (as well as Puerto Rico), Canada, the Republic of Panama and Mexico. Decisions regarding acceptance of patients from other locations are generally made by the boards of governors, in conjunction with the chiefs of staff, at each individual hospital.
Download an application for treatment:
Application for Treatment and Application Instructions (pdf) (English)
Application for Treatment and Application Instructions (pdf) (Spanish)
Application for Treatment and Application Instructions (pdf) (Russian)
Application for Treatment and Application Instructions (pdf) (French)
Canadian hospital only French or English
Applications can also be obtained from any Shriner or Shrine Club; by writing to Shriners Hospitals for Children, P.O. Box 31356, Tampa, FL 33631; or by calling 800-237-5055. (In Canada, call 800-361-7256.) Completed applications should be returned to the nearest Shriners Hospital for Children.
Notice of Privacy Practices:
English
Spanish
Russian
French
For information about a completed application or for other questions, please e-mail patientreferrals@shrinenet.org, or call 800-237-5055 or 800-361-7256 in Canada. Both lines are staffed weekdays between 8 a.m. and 5 p.m. EST.