SHM Grant Application

1

Choose Your Grant* This field is required.

Lifeboat Grant

Harbor Bridge Grant

Compass Grant

2

Your Name* This field is required.

First Name

Last Name

3

Your Email* This field is required.

example@example.com

4

Your Best Contact Number* This field is required.

Area Code

Phone Number

5

Length of sessions requested:NOTE: To ensure the most effective use of available grant points, requests for sessions of 120 minutes or longer DO require a brief description of the need. Please share why this extended time is necessary for your or your hero's current situation.

6

I am requesting a grant because (Check All That Apply)* This field is required.

Fixed/Low Income: My current income does not allow for specialized wellness care.

Emergency Hardship: I have experienced a recent job loss, medical emergency, or housing crisis.

Long-term Barrier: My financial situation prevents me from accessing regular neuromuscular treatment.

Acute Pain Crisis: I am currently in a high-pain cycle that is affecting my daily life.

Migraine Management: I am seeking relief from chronic migraines/headaches.

Neurodivergent Support: I am seeking specialized care for Autism/ADHD/Sensory processing.

Neuromuscular Condition: I have a chronic physical condition that requires consistent maintenance.

Oncology Support: I am seeking physical relief from the side effects of cancer treatment or recovery.

Post-Surgical/Medical Recovery: I am recovering from a major medical procedure and need restorative tissue work.

7

Share More About Your JourneyPlease use this space If you wish to share why you are seeking a safe harbor today and how this grant will impact your quality of life.

8

Hero's Name Nomination* This field is required.

Prefix

First Name

Last Name

Suffix

9

Hero's Email

example@example.com

10

Hero's Phone Number

Area Code

Phone Number

11

Share why you think this person is an 'Anchor' in our community and how you think they could benefit from a session.* This field is required.