Persons struggling with end of life issues and/or terminal diagnoses have many and varied needs. They may also have regrets (estrangements from family members, etc), wishes (to do something “one last time”) and lack of comfort care needs (air conditioning, better mattress). The Charitable Fund is willing to assist.

Complete ALL questions on the Request Form. Omitting information can cause denial or delay in obtaining funds. If patient is being cared for by a medical facility, provide the name and phone number of the social worker, nurse, or physician. Contact us for more information or with questions

ALL REQUESTS WILL BE CONSIDERED. Make sure to complete the form in its entirety. Providing adequate details will allow a quick turn-around.

Click the button below to complete and submit the Request Form, or, if preferred, “Contact us” to email your questions or to speak with someone.