Contact Us
Apply for Aid

 

 

Application Guidelines

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Requirements to apply for aid:

1. Child must be under the age of 18.

2. Child must have an official diagnosis recognized as a muscular disorder.

 

Application Instructions:

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Please copy the below application, fill entirely, and send to Anniesmiracle@outlook.com.

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1. Child's Name:

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2. Parent's Name:

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3. Parent's Address:

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4. Parent's Phone Number:

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5. Assistance Needed:

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6. Please submit proof of insurance claim/denial or letter from prescriber stating insurance denied treatment.

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7. Proof of Diagnosis (can be any documentation from medical provider showing diagnosis).

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8. Proof of income for last 30 days or tax return for previous year (preference to lower income families first)

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9. Please submit a letter from yourself explaining why the treatment is necessary or the funding needed and background.

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10. Please advise if you would be open to sharing a picture of your family/child for future use on the website. 

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