Apply for a Grant
To ensure an equitable opportunity for all applicants, we invite you to review our grant eligibility guidelines
1
Funding Criteria
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An adult (18 years of age or older) must complete and apply on behalf of any recipient under 18.
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Must be under the care of a licensed medical provider. Please have your provider complete the Provider Certification of Medical Necessity form before applying.
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Each person is eligible for one grant every 12 months. Limited to one request per funding category per year.
2
Qualifying Income
To be eligible, a family’s Adjusted Gross Income (AGI), as shown on line 11 of the current year’s federal tax return, must not exceed the limits listed below.
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Family Size of 2 – $65,000 or less
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Family Size of 3 – $100,000 or less
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Family Size of 4 – $135,000 or less
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Family Size of 5 or more – $170,000 or less
Applicants must submit the current year's federal tax return (IRS Form 1040). If you've filed "married filed separately," please include both tax returns. **If your tax return doesn’t accurately represent your current circumstances, please feel welcome to apply and explain your financial need. Priority is given to applicants who meet our qualifying income guidelines.
3
Documentation
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Provider Certification of Medical Necessity (patient portal chart notes, prescriptions, or IEP evals not accepted).
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IRS Form 1040
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Vendor quote: Please include the total price from the vendor. Links to pricing will not be accepted.
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Insurance Denial: Submit a letter of denial or exclusion of benefits.
Our Grants
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Ready to Apply
Click below to get started.
Don't forget to attach your documents! Your application will not be reviewed without all the required forms.