Shrine Hospital Application

Eligibility and Application

Children up to age 18 are eligible for care at Shriners Hospitals for Children if, in the opinion of our physicians, there is a reasonable possibility they can benefit from the specialized services available. Acceptance is based solely on a child’s medical needs. A family's income or insurance status are not criteria for a child's acceptance as a patient.

For patients at Shriners Hospitals for Children, ability to pay or insurance coverage is never an issue. There is no charge for any care or services provided within Shriners Hospitals facilities.

Application Procedures for Orthopaedic Care, Spinal Cord Rehabilitation, Cleft Lip and Palate Repair and Non-Emergency Burn Care

Download an application for treatment inEnglishSpanish or French (Canada residents only). Forms can also be obtained from any Shriner or Shrine Club; by writing to Shriners Hospitals for Children, P.O. Box 31356, Tampa, FL 33631; or by calling the Shriners Hospitals (800) 237-5055. (In Canada, call (800) 361-7256.) Completed applications should be returned to the nearest Shriners Hospital for Children. See the application help guide for additional assistance.

For information about a completed application for other questions, please e-mailpatientreferrals@shrinenet.org, or call (800) 237-5055 or (800) 361-7256 in Canada. Both lines are staffed weekdays between 8 a.m. and 5 p.m. EST.

Application Procedures for Emergency Burn Care

The sooner a child with burn injuries reaches a Shriners Hospital that specializes in burn treatment, the better the chances of recovery.

In an emergency, the referring physician treating a child with burn injuries should telephone the chief of staff at the Shriners Hospital in Boston, Cincinnati, Galveston or Sacramento and indicate that there is a patient needing emergency burn care.

The telephone numbers for emergency admissions Shriners Hospitals specializing in burn treatment are:

  • Boston: (800) 255-1916
  • Cincinnati: (800) 875-8580
  • Galveston: (409) 770-6733
  • Sacramento: (916) 453-2111

Transportation issues are handled on a case-by-case basis. The hospital's care coordinator will assist families with transportation details. Bagdad Temple has funding available to help with costs associated with travel to and from the Shirners Hospitals for Children.  Please contact the Bagdad Temple office at (406) 782-6949 for more information.