Please read ALL terms and conditions before submitting your application.
How it Works:
  • Applications will be open and accepted every month.

  • When applications are open, they will be for assistance for travel for appointments and surgeries that have been scheduled for the following month. 

  • Applications will be accepted on a rolling basis and will open as long as funds are available.

  • Download, read, and fill out the application. Attach any necessary confirmations. Email everything to

Application Status: OPEN

February 1 - February 28

Assistance for appointments scheduled between:

March 1 - March 31


January 1-31: Applications are accepted for assistance for all appointments scheduled between February 1-28.

February 1-28: Applications are accepted for all appointments that have been scheduled between March 1-March 31.

And so on...

Due to the COVID-19 pandemic, all assistance will be given virtually through e-mail.

Click icon below to download application form