Samantha Remington Angel Heart Foundation Medical Grant

The Samantha Remington Angel Heart Foundation provides financial support to families facing serious medical hardships. This is a rolling grant program with no fixed deadline.

Geographic Scope: United States

Focus Areas: Medical procedures, treatment, and ongoing care for serious, life-threatening conditions

Eligibility

• Applicants: Parents or legal guardians of children 21 years old or younger, OR adults who live in the United States and receive/pay for medical procedures, treatment, and ongoing care
• Medical Condition: Must be serious and life-threatening in nature
• Financial Burden: The required procedure, treatment, and care must impose a serious financial burden on the family
• Child Dependency Requirements: If applying for a child, the child must:
  • Live with you 51% or more
  • Be listed as a dependent on your most recently filed IRS 1040
  • If not listed on your most recently filed IRS 1040, provide copies of both your most recently filed IRS 1040 and the most recently filed IRS 1040 on which the child is listed as a dependent

Award Limitations

• Per 12-Month Period: Limited to 85% of the fund balance
• Lifetime Maximum: Limited to two grant awards unless the Board votes to exceed the maximum for good cause shown
• Reapplication: Unsuccessful applicants must wait 12 months before reapplying, unless the medical condition and requested items have significantly changed

Non-Discrimination

The Foundation does not discriminate based on race, color, creed, religion, sex, sexual orientation, disability, marital status, ancestry, or national origin.

Contact Information

Address: 645 E Wiggins St. Superior, CO 80027

Additional Information

• Applications may be reviewed by a health care professional appointed by the Foundation to verify the procedure, treatment, or care meets accepted medical standards
• The Board may request additional information and documentation after application submission

Application Process

1. Submission Method:
   • Submit application in writing via email to the Foundation Board of Directors
   • OR complete the online grant application form on the website
2. Required Materials:
   • Letter outlining your situation describing:
   • Your medical condition or your child's medical condition
   • The procedure, treatment, or ongoing care needed
   • The financial burden imposed on your family
   • Financial Documentation (may be requested by the Board):
   • Copies of W-2's
   • Recent pay stubs
   • Recent tax returns
   • Insurance limits documentation
   • Dependency Documentation (if applying for a child):
   • Copy of your most recently filed IRS 1040
   • If child is not listed on your 1040: copy of the most recently filed IRS 1040 on which the child is listed as a dependent
   • Photo (optional, .jpg format, max 100 MB)
3. Publicity Release:
   • Complete the Consent to Use Photo, Story, and Name for Promotional Purposes form
   • Choose one of three consent options:
   • Consent to use name, story, and photo
   • Consent to use story but not photo
   • No consent to public use (does not affect eligibility)
   • Include signature and date
   • If applicant is under 18: Include parent/guardian signature
4. Contact Information Required:
   • Name (first and last)
   • Email address
   • Phone number
5. Review Process:
   • The Board will evaluate applications based on established criteria
   • May request additional information after submission
   • May request health care professional review to verify medical appropriateness
   • Board will notify applicant of decision