To apply for financial assistance, please complete this form with your hospital social worker. To be eligible, you must have a child in treatment at Yale New Haven Children's Hospital, Connecticut Children’s Medical Center or be a CT resident in treatment out of state. We offer financial, food and transportation aid paid including, but not limited to: mortgage, rent, utilities, gas and grocery debit cards. Other items are reviewed on a case-by-case basis. We do not provide support for medical expenses. Your application must be completed in full, demonstrating need and providing verifiable information. To be eligible for services, you consent to non-identifying information being included in grants, reports and publicity.
Completion of our form does not guarantee approval.