Apply for a medical grant

Please complete the form to the best of your ability. All of your responses will remain confidential.

We encourage you to apply if you are seeking medical assistance.

Applications are currently closed until August 2026!

First and Last Name*

Email Address*

Phone*

Home Address*Medical Background: Please describe your current medical condition or diagnosis, how long you have been dealing with it, and the type of treatment or care you require.*Financial Need: Please describe your current financial situation and how it affects your ability to cover medical expenses. If applicable, include information about insurance coverage and any significant costs not covered by insurance.*Use of Funds: How do you plan to use the funds from this grant? (e.g., hospital bills, medications, therapy, assistive devices, home care, etc.)*
Impact of Funds: How would receiving this grant improve your health, well-being, or quality of life?*Additional Information: Is there anything else you would like us to know about your situation? You may also mention any supporting documents you would like to include (such as medical bills, doctor's notes, or insurance statements*How did you hear about this grant and The Hallie225 Foundation?*

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Legal Notices and Disclaimers: Information on this website is for general informational purposes only and should not be considered legal or professional advice. Hallie225 is a 501(c)(3) non-profit tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code and is a corporation organized under the laws of Illinois. Because donations may be tax deductible, we supply donors with documentation acknowledging all donations that may be used by the donor, for personal tax purposes. Hallie225 respects the privacy and safety of all site visitors and donors. On or through this site, we collect data or information that may personally identify you only when it is voluntarily offered by you. Any and all such information is protected in accordance with our privacy and safety policy. For more information our privacy and safety policy, please open this link.