Apply for Individual Medical Funding and Grants

If you would prefer to submit the form by post/email, click here to download a PDF  for printing, to complete and post or scan for emailing.

If you leave this page before submitting the form, the information you have entered will be saved for your return.




Please include in this application some scanned paperwork to support your claim (e.g a letter from your GP, Physiotherapist or Social Worker)

Your application will not be considered if you do not upload paperwork. If you do not have scanned paperwork then please use the PDF application form and post it to us.

Your referee will be informed of the outcome of your application automatically unless
you tick the box.


If your application is successful, do you consent to our using personal, but non sensitive, information about you (which may include a photograph of you) in our newsletters/other publicity?

 

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