• Family Assistance Request

    Family Assistance Request

    Supporting Pediatric Cancer Families
  • Gabriella's Smile Foundation is committed to supporting pediatric cancer families through life's unexpected challenges. Through the generosity of our donors and community partners, we may be able to provide limited financial assistance, gift cards, emergency household support, or other resources based on your family's needs.

    Assistance is subject to eligibility, program guidelines, demonstrated need, and the availability of funding or donated resources. Completing this request does not guarantee assistance.

    Because Gabriella's Smile Foundation is committed to supporting families beyond financial assistance, we encourage applicants to stay connected with us whenever possible. Staying connected may include attending programs or events, responding to occasional check-ins, staying in touch through our app, social media, or other communications, and participating in Foundation programs and opportunities as your family's schedule allows.

    We understand that every family's circumstances are different, and participation is never required. However, staying connected allows your family to receive ongoing resources, encouragement, and opportunities to connect with other families throughout your journey.

  • Eligibility Requirements

    To be eligible for financial assistance, applicants must:

    ☑ Have a child currently receiving cancer treatment or have completed treatment within the past 12 months.

    ☑ Be experiencing financial hardship related to the child's diagnosis.

    ☑ Have not received assistance within the past 6 months.

  • Please Note: 

    • Priority is given to Courage families (with a child currently in active treatment). Assistance for Thriving and Legacy families may be available based on demonstrated need and the availability of funding.
    • This program is available only to families who have previously completed the Gabirella's Smile Foundation intake process.
    • Completed applications are considered in the order they are received. Incomplete applications will not be considered untill all required information has been submitted.
    • Assistance is available only while funding is available.
    • Submission of an application does not guarantee assistance.
  • Family Assistance Request

    Family Assistance Request

    For pediatric cancer families
  • Gabriella’s Smile Foundation may provide continuing financial assistance to families experiencing ongoing need, based on available funds. 

    While event participation is never required, families receiving ongoing assistance are asked to remain connected with Gabriella’s Smile Foundation. This may include completing brief check-ins, responding to outreach, attending events when able, or sharing feedback to help us better serve families.

    Continuing assistance is reviewed periodically and is not guaranteed indefinitely. Life circumstances are understood to change, and flexibility is always applied.

     

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  • Have you received a financial assistance or gift card from GSF in the last 6 months? (Available to those with a child in current treatment once every 6 months)*
  • Tell us what type of emergency assistance you are requesting:Assistance is subject to eligibility and the availability of funding, gift cards, and other resources.*
  • I authorize Gabriella’s Smile Foundation and its agents and representatives to contact the medical provider if additional information is needed. I authorize the above named medical provider to release to Gabriella’s Smile Foundation and its agents and representatives any information and medical records deemed necessary by Gabriella’s Smile Foundation to verify my child qualifies for assistance. I acknowledge that Gabriella’s Smile Foundation will pursue and is entitled to restitution of assistance received if it is determined that the information submitted on this application is false.*
  • By submitting this application, I understand that continuing financial assistance requires ongoing communication with Gabriella’s Smile Foundation.*
  • Should be Empty: