Global Patient Services Request for Ronald McDonald House

If you would like to stay at the Ronald McDonald House, please fill out the information below. Please note: There can only be a total of four people (including the patient, adults and children) in a Ronald McDonald House room. Fill out the first, middle, last name and date of birth for each person who will be staying in the room.

Requests submitted weekdays between 8 am - 4 pm will be processed as soon as possible. After-hours requests will be processed the following business day. For immediate lodging requests, submit our Hotel Request Form.

The Ronald McDonald House runs background checks on all adults prior to reservation confirmation. This form is a reservation request and does not guarantee availability. You will receive an email from Global Patient Services within one to three business days confirming your request has been sent to the Ronald McDonald House.

The Ronald McDonald House will contact you directly to confirm your reservation.

Fields marked with the asterisk * are required.

For Immediate Lodging Options

Click here to submit our hotel request form.

Global Patient Services Request for Ronald McDonald House

If you would like to stay at the Ronald McDonald House, please fill out the information below.

Patient Name Patient Date of Birth (mm/dd/yyyy) Department/Specialty Type of Visit Address City State Zip Code Phone Number Email Your First Name Your Last Name Your Relationship to Patient Best Way to Contact You Date of Arrival Expected Number of Nights Number of Guests Guest #1 First Name Guest #1 Middle Name Guest #1 Last Name Guest #1 Date of Birth (mm/dd/yyyy) Guest #2 First Name Guest #2 Middle Name Guest #2 Last Name Guest #2 Date of Birth (mm/dd/yyyy) Guest #3 First Name Guest #3 Middle Name Guest #3 Last Name Guest #3 Date of Birth (mm/dd/yyyy) Accessible Features Will you need hotel accommodations in addition to your Ronald McDonald House reservation to accommodate additional family members and/or guests?

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For Immediate Lodging Options

Global Patient Services Request for Ronald McDonald House