Apply for Assistance

In order to qualify for assistance, a child must be medically involved;  i.e., currently or recently hospitalized or receiving ongoing medical treatment at a medical facility or at home through specialized nursing care.

Please have the social worker or health care professional assigned to your child fill out these necessary forms and fax or mail them back to us.   The “Patient Information Form” must be completed by a health care professional in order for us to process a request.

Our board will review each application as soon as they are received. Social workers will be notified if the CJR Memorial Foundation is able to assist. We cannot guarantee every need will be met but will help however possible based on priority and funds available.

Eligible expenses will included but are not limited to:
Mortgage
Rent
Daycare
Travel Expense
Lodging
Utilities

To date, The CJR Memorial Foundation has supported families of critically ill children from across the country.