Thank you for referring a family to Lucy's Love Bus! We are looking forward to working with them; please fill out the information below as able and allowed, and we will be in touch with you or the family directly to discuss the availability of our funding and next steps. (The fastest way for us to help a family is to have them complete our application!)

Please get in touch with Jackie directly at or 978-764-4300 if you have any additional questions. 

Family Referral

The following are questions about the family and child so that we can get in touch with them as soon as possible. Please fill out as much of the following information as you feel comfortable sharing, and only with the family's permission. Knowing a child's state of residence will allow us to immediately assess how much funding we can offer the child, and additional information such as age and therapies of choice will allow us to begin the process of searching for a perfect person to work with them.

Child's chosen therapies?
  • We must secure a medical permission form signed by the child's oncologist clearing his/her participation in the therapy of his/her choice. Please click here to download that permission form; it can be sent to us by fax/email/mail separately from their complete application from your directly, but must be received before the child begins services.

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