Happy Soles Grant for Infertility Treatment
The Happy Soles Grant provides funding to families receiving treatment in Delaware, Chester, Philadelphia, Montgomery or Bucks counties who are experiencing infertility as a result of cancer treatments or for children who are preserving tissue and eggs/sperm as a result of hematological issues. Eligible families can apply for a grant to cover part of the cost of fertility treatments. Grants are $500-$2500 and are paid directly to the clinic or agency providing fertility treatment.
Eligibility Requirements. Check all that apply:
*
Applicant or child is receiving treatment in one of the following 5 counties: Bucks, Delaware, Chester, Philadelphia, or Montgomery County, Pennsylvania
Applicant has either experienced infertility as a result of cancer treatment OR their child with hematological issues requires preservation of tissues and eggs/sperm.
An oncology or hematology provider can recommend and provide documentation that fertility preservation, tissue preservation, treatment, or surrogacy is necessary and appropriate due to a cancer diagnosis or a hematological condition.
Name of Applicant
*
First Name
Last Name
Name of Child, if applying on their behalf
First Name
Last Name
Address of Applicant
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Applicant Email
*
example@example.com
Applicant Phone Number
*
-
Area Code
Phone Number
Grants may be used for a frozen embryo transfer, embryo preservation, egg preservation, semen preservation, tissue preservation, storage fees, adoption, and surrogacy. Please describe what you need the grant for.
*
Please upload a signed physician verification from your healthcare provider to confirm cancer diagnosis or hematological issues or be prepared to email that before the grant is released.
Browse Files
Cancel
of
Please describe your/your child's treatment, including whether the treatment is complete or ongoing.
*
Save and Continue Later
Submit
Print Form
Should be Empty: