Wish Request Form

A final wish may be requested for a person who:

• Has a terminal diagnosis and is receiving palliative or end-of-life care, usually within the last year of life; and
• Requires specialist transport to visit a place of personal significance due to medical needs, mobility limitations or logistical barriers.

To ensure each wish is carried out safely and with dignity, the recipient’s attending clinician must approve the wish. This confirms that the individual is medically able to undertake the journey, taking into account their health status and diagnosis. The clinician may also help arrange additional medications or equipment required to support the recipient for the duration of the wish.

Requesting a final wish earlier – rather than waiting until the last days of life – offers important benefits. Early referrals allow time for careful planning, clinical review, and coordination of volunteers, transport, and equipment, increasing the likelihood that the wish can be fulfilled safely and as intended. Earlier wishes are also often more comfortable and meaningful for recipients, who may have greater energy, awareness, and ability to participate. Families also benefit from reduced stress and the opportunity to share unhurried, meaningful moments together. An early wish helps create lasting memories – when they can be most fully experienced.

To request a wish please complete the below full to the best of your knowledge. On successful submission, you should receive a copy of the submitted form.