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Hospital referral

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Thank you for referring a family to Lucy's Love Bus! Our individual funding for integrative therapies is available for childhood cancer patients in New England.

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! We will get in touch with the family and send them the application, which is needed before we can pay for services, so directing the family to our application is the fastest way to help them get started with services!)

Please get in touch with Kerry directly at kerry@lucyslovebus.org or 781-454-8535 if you have any additional questions. 
The BEST way to help the family is to direct them to our application at lucyslovebus.org/application. This is the fastest way to get them connected to therapies.

Family Referral
Your name
Your job title/connection to family
Hospital/organization
Your phone number

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.

This is the referral application for integrative therapy support (paying for massage, acupuncture, dance, swim, therapeutic horseback riding, etc). We do not offer direct financial assistance; for that support, please see our Resources page.

By clicking here, I certify that any information provided about the family is shared with their permission.
Patient's Name
Patient's DOB
If the patient is over the age of 18, please advise if we should contact them directly, or contact the guardian.
Patient's diagnosis
City/town of residence
State of residence
Name of person to contact
Relationship to patient
Contact's email
Contact's phone number
Contact's preferred method of contact?
Contact's preferred language
Patient's chosen therapies?

This referral form is so that we can get in touch with a family, tell them more about our programs, and have them complete a full application. The family will still need to complete the full application before moving forward. 

Directing them to the full application is the fastest way to connect them to assistance.

  • 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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