Purpose:
The Emergency Assistance Fund provides short-term financial support and resources to individuals and families affected by epilepsy in Colorado and Wyoming. The fund is intended to help during an acute, one-time financial crisis. It is not designed to provide ongoing financial assistance or long-term sustainability.
Eligibility:
- Residency: Applicants must reside in Colorado or Wyoming and be directly impacted by epilepsy.
- Frequency of Support: Applicants who receive funding for two consecutive calendar years are not eligible for additional assistance for the following 24 months.
Funding Considerations:
- All requests are evaluated on a case-by-case basis.
- Decisions are based on multiple factors, including individual circumstances and the Foundation’s current budget.
- The amount and type of assistance may vary depending on need and available resources.
Instructions
1
Review Eligibility Criteria before completing this application
2
Complete entire form
Incomplete applications may be subject to denial.
3
Proof of Diagnosis
Proof of diagnosis and other supporting documents may be requested upon review of application.
Eligibility Criteria
To qualify for Emergency Assistance Funding, applicants must meet the following criteria:
- Diagnosis of epilepsy. Documentation may be requested. Approved forms include a photo of your prescription or letter from your doctor.
- Need must be related to the effects of epilepsy.
- Assistance must benefit the person with epilepsy or their immediate family members/care partners.
- Assistance requested/provided does not duplicate other aid received for the same costs.
- Financial need will be determined using standard income guidelines as a reference point. If your household income is above these guidelines but you experience increased expenses related to epilepsy, please explain this in the application.