Apply for Support
Jack’s Assistance Program is the heart and soul of our organization, providing financial assistance to families of children with cancer or special needs to help with transportation, food and housing costs associated with out-of-area treatments. We also support costs associated with equipment and medical bills.
An application is required to qualify for Jack’s Assistance Program. Our goal is to help your family, so all applications are reviewed with the goal of providing some sort of assistance.
If you have an emergency, please call us at (805) 547-1914 so that we can attempt to assist you urgently.
Otherwise, the initial application process is as follows:
Please download and fill out the following application and then upload to the form below.
for returning families, the paperwork is simplified
Select the buttons below for your type of requests. We have a Request Form for “TRAVEL” to a Medical Appointment, or “OTHER” for our therapy programs, medical equipment, etc.
To apply for assistance, please fill out the appropriate paperwork as noted above. You can now complete the forms online in both English and Spanish. Send the completed application to [email protected], fax it to (805) 592-2018 or mail it to:
Jack’s Helping Hand
P.O. Box 14718
San Luis Obispo, CA 93406
Initial Applications and Assistance Requests are kept for 2 years. After 2 years, a family must complete a new full Application.
For more information regarding Jack’s Assistance Program, email [email protected].
Meet Rosie!
Rosie was born prematurely at 33 weeks, requiring an extensive NICU stay at Valley Children’s Hospital in Madera. She was diagnosed with Trisomy 21 (Down syndrome), along with a congenital heart defect known as VSD. She was also born with Long Gap Esophageal Atresia, which required a G-tube to be placed shortly after birth.
Because Rosie was born weighing only 3 pounds, she had to wait six months in the NICU before undergoing open-heart surgery. Shortly after, she was transferred to Lucile Packard Children’s Hospital to have her esophagus repaired. Rosie was finally able to come home at around 10 months old.
Rosie now follows up with 10 different specialists at Stanford for her medical care, and Jack’s Helping Hand has provided support through travel assistance and coverage of multiple hotel stays. This support has allowed her family to focus on Rosie’s health without the added financial stress of managing numerous appointments throughout the year.
Rosie is now 3 years old and thriving at home. She loves playing with her older brother, is currently learning how to use her medical walker, enjoys long stroller walks, and loves her homemade purees.
Her journey is a powerful reminder of the strength and resilience of the children and families we are honored to support each day.