Applications

The Foundation is a nonprofit organization that provides key pieces of equipment not covered by private or government sponsored insurance. The equipment must be deemed medically necessary to meet rehabilitation and quality-of-life goals.  The Foundation has two programs to support our mission, the Healthcare Grants Program and the Loaned Equipment Program.  With a small staff and many volunteers, we strive to support Georgia’s medically fragile children, from birth to age 21 statewide.


Please click here for a list of our lift vendors

Applications

We have three (3) types of applications.  Please download and fill out the application that applies to you. Applications will open in a new window. To download to your desktop, right click and select “Save target as…”

General Grant Application
Required for both Healthcare Grants and Loaned Equipment. This includes the Letter of Medical Necessity and Consent Release forms that must be included for consideration.
Download PDF

Transportation Grant Application–Required, along with General Grant Application for vehicle lifts.
Download PDF

All-Terrain Wheelchair Reservation (Loaned Equipment)
Complete only if you are interested in borrowing this specialty recreational wheelchair.
Download PDF

Requirements & Deadlines

A family may receive one (1) Healthcare Grant item and two (2) Loaned Equipment items per year. Include with your application:

  • copy of your child’s Birth Certificate
  • cost quote of the item(s) being requested
  • completed letter of medical necessity from your therapist
  • copy of your latest tax return

The Review Committee meets quarterly beginning in January. Deadlines for applications are as follows:

  • March 31, for April meeting
  • June 30, for July meeting
  • September 30, for October meeting
  • December 31, for January meeting

You will be notified in writing within 21 business days after the meeting regarding the decision made on your request.  If you have any questions, please call our office at 770.951.6111. Please Do Not Fax Applications! Only those received by mail can be processed and considered.

Privacy is respected and medical information is not shared beyond our review and grant allocation process.  Mail forms and supporting documents to:

Fragile Kids Foundation
3350 Riverwood Parkway
Suite 1400
Atlanta, Georgia 30339