Ronald McDonald House: Springfield
Day Use Referral Form
How to Refer a Guest Family to Ronald McDonald House: Springfield
Ronald McDonald House: Springfield is committed to providing a clean, healthy, family-centered, home-away-from-home space for families to rest and recharge. The health and well-being of our guest families, staff, and the communities we serve are top priorities.
All referrals must come from the patient's medical team, typically a hospital social worker, child life specialist, nurse, or doctor at a partner hospital or medical facility.
A day use referral request does not guarantee a reservation. Confirmation calls are encouraged to verify a family can be accommodated.
We rely on our medical partners to refer families that meet our eligibility requirements and are a good fit for shared communal spaces.
Please keep the following in mind when making a referral:
• The patient must be under 21 and receiving medical care at your hospital facility.
• The parent/guardian must be 18+ to request a room.
• All adults must present valid, non-expired photo identification.
• Families must have permanent residence to stay at Ronald McDonald House: Springfield.
• Only 3 guests/room per the City of Springfield occupancy rules.
• All guests must be free from any communicable illness, infectious disease, or physical condition that may endanger the health of other residents in a communal environment, particularly those who may be immunocompromised.
• All members of the guest family must meet Ronald McDonald House Connecticut and Western Massachusetts requirements, including (1) having no current drug/alcohol abuse, (2) having no conviction relating to domestic violence or crimes against children, and (3) having no open case with the Department of Children and Family Services, without further conversation with Ronald McDonald House Family Services staff before referral.
• We are unable to support families who are in transition between residences.** At this time, there is no restriction on the number of miles a family must reside to be referred to Ronald McDonald House: Springfield. We will do our best to accommodate all families. ** This is subject to change
• There is a suggested room contribution of $5 per use. Please inform families of this when completing paperwork. All guest families are informed upon registration. No one is turned away due to an inability to contribute.
For questions, please call 413.271.5683