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Contact Us
Apply for Aid

Contact Us

Thank you for your submission. Please allow us 24 hours to get back with you.



Application Guidelines

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:

Please copy the below application, fill entirely, and send to

1. Child's Name:

2. Parent's Name:

3. Parent's Address:

4. Parent's Phone Number:

5. Assistance Needed:

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

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

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

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

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

We Need Your Support Today!

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