Apply for Assistance

Financial grants are provided in the form of direct bill pay and pre-paid expense cards based on need.

Eligibility

To qualify for financial assistance from the Sammy Gelband Foundation:

  • Applicant must apply through a Social Worker from their healthcare facility.

  • Child must be five years of age or younger at the time of application.

  • Child must have at least one parent who is a U.S. citizen.

  • A licensed medical professional must provide both a diagnosis and the child’s current health condition.

  • Families must have financial needs as a result of their child’s illness.

  • The application must be fully completed.

Healthcare providers can email info@sam.codpixels.com for an online link to our application. 

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Please begin the application process for financial assistance by completing the form below. We look forward to hearing from you.