Refer a child

Refer a child to Simon’s Heroes and our heroes will do all they can to help.

Do you need our support or know someone that does?

Simon’s Heroes provides resource and opportunities to its beneficiaries that are not always available through the NHS and other funding routes, but go a long way towards helping children with life limiting illness lead more independent and fulfilling lives.

To date, this has included the purchase of medical equipment, respite breaks for families who spend 24/7 supporting their children and home improvements for those who have little time for anything else outside of caring. It has also helped make dreams come true, funding treats and experiences for children and their families coping with debilitating illness, giving them a reason to smile.

If you know of a child that would benefit from similar support, please complete the application form below and return to us.


The child needs to be a UK resident, living in Derbyshire, Leicestershire, Warwickshire or Staffordshire  and aged 17 years and under with a life limiting illness.

In addition the child should not have previously received any help from us.

We accept referrals from parents, guardians, medical professionals and family friends.

What happens next?

Once your application form has been submitted, a member of our team will be in touch to arrange a home visit to meet with the family. This will normally take place within 3-4 weeks from date of submission.

How to apply

Apply online

Simply click the button and fill out the form to apply online.

by email

Download the form, email the completed form back to


by post

Download the form, fill in all the fields and then post back to:

38 Teign, Hockley, Tamworth,
Staffs, B77 5QP.