Grants
Patient Financial Support Application
 

The Patient Financial Support Program is a Scholarship Program. It provides modest financial assistance to qualified patients with chronic and/or life threatening illnesses who need help paying for medical care and/or living expenses such as mortgage/rent payments or utility bills. The scholarship (the award) is competitive and thus the funds available are limited.

The program will generally fund up to $2,000 at one time within one calendar year.

Eligibility Requirements

  1. The applicant must be a patient receiving ongoing medical care.
  2. The applicant's liquid assets may not exceed $2,000.
  3. The applicant must have his/her physician verify his/her current medical condition.

Chances for Funding

The Foundation receives numerous applications throughout the year and funds less than one third of them. Even though an applicant may meet the eligibility requirements, he/she may not be awarded due to the volume of applications and limited resources.

The review of the application is based on the demonstration of need. If funds are awarded, the payment will go directly to the service provider and not to the applicant.

When To Apply

Applications for this program are accepted by the Foundation any time throughout the year. Due to the nature of need, the Foundation will review and make a decision generally within two weeks of receiving the application.

How to Apply

               Click below to download the Patient Financial Support Grant Application documents.

                           Patient Authorization

                           Patient Application for Financial Support

                           Patient Financial Support Guidelines

           Complete them with your physician and social worker, if applicable.

 

           Complete the application in its entirety. Applications that are incomplete or do not have the necessary documents as

            back-up will be declined.

 

            Send the application to the Foundation's Grants Department either by email to agore@phfpbc.org; fax to (561)

            833-0070; or mail to Palm Healthcare Foundation, 1016 North Dixie Highway, West Palm Beach, FL 33401,

             Attn - Grants Department.