Start a case

Tell us how we can help your child

This first step takes a few minutes and shares only basic contact information — no medical records, no child’s full identity, no payment. A coordinator reads every inquiry and replies personally.

This website is not for emergencies.

If a child may be experiencing a medical emergency, contact local emergency services immediately. In the United States, call 911.

No medical details in this form, please

Do not include your child’s full name, date of birth, diagnosis details, or any documents. If your case is eligible, we will invite you to a secure channel for records.

This form needs JavaScript

We use a small in-browser security check instead of a third-party tracker, and it needs JavaScript to run. Please enable JavaScript, or email us at cases@cincykidsbridge.org — a coordinator reads every message.

About you

Parent / legal guardian first name

Last name

Email address

Telephone with country code

Country of residence

Preferred contact method

Best time to contact you (with your time zone)

About your child’s situation

Child’s age range

Broad area of need

What help do you need?

How would care likely be funded?

Have you already contacted or been accepted by a U.S. provider?

YesNo

Anything else we should know? (no medical details, please)

Consents

I agree to be contacted about this inquiry. I understand this is not emergency care, and emergencies must go to local emergency services. I have read the Privacy Policy and Terms of Use. Optional: I would like to receive occasional updates and resources by email. Never required, withdraw any time.

Free, no obligation. A coordinator replies personally — no automated decisions.

What happens after you submit

1You receive a confirmation email with a reference number.
2A coordinator reviews your inquiry and contacts you via your preferred method.
3If coordination fits, you get a clear plan — and a secure channel for records.

Why so few questions?

By design. Public forms should not carry medical records or a child’s identity. We ask for the minimum needed to start a conversation — everything sensitive moves later, through a secure invitation.

Prefer to talk first?

Request a call and a coordinator will confirm a time that works in your time zone.

Request a Call