Christopher’s Cure Hardship Fund Application
Financial assistance will be provided to families with critically ill children that demonstrate a financial need that is a direct result of the child’s illness (such as loss of income, incurred travel expenses). The application should be submitted through your social worker at the medical facility you’re receiving treatment and directed to Robin Hirth at Southwest Association Management.
The Christopher’s Cure Hardship Fund Application must be completed in its entirety to determine qualified applicants for financial assistance. Along with the completed application, please provide copies of bills or invoices for which you are requesting assistance.
The Christopher’s Cure Hardship Fund will only pay for expenses that have a direct impact on the patient’s quality of life. Payments are made directly to the creditor upon verification of amount. Subject to approval, eligible monthly expenses include:
- Mortgage or Rent
- Child Care Facilities
We cannot assist with: medical insurance payments, medical bills, credit card payments, cable TV or clothing.
Christopher's Cure Hardship Fund Application
To download the Fund Application, click on the link below:
Christopher's Cure Hardship Fund Application (PDF Format 29 KB)
The application form is available in PDF format. If you do not have Adobe Acrobat, you can download the Free Acrobat Reader below:
Mail, fax, or email the completed application form to:
Southwest Association Management
Robin Hirth, Account Manager
7225 W. Oakland St. Suite 1, Chandler AZ 85226
phone: 480-496-4010 | fax: 480-858-1802 | email: firstname.lastname@example.org