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CHF Comfort + Support
Children with Down syndrome can be born with various medical issues that require surgery or
intervention of some kind. This can be a huge emotional burden on the families involved. We provide
health related supportive services or products which may include providing extra comfort items to cope
with hospitalization or a health condition associated with Down syndrome. It may also include
reimbursement of extensive costs of travel.
In order to apply for this service, the following information is required for review:
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Guardian Name
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Your answer
Address
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Your answer
Phone Number
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Your answer
Name of Person with Down Syndrome
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Your answer
Date of Birth of Person with Down Syndrome
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MM
/
DD
/
YYYY
Are you a brand new parent? Welcome!!
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Yes
No
Specific Medical Condition being experienced by the person with Down syndrome or if you are in the NICU please state that here (type 'none' if this doesn't apply)
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Your answer
Location/Hospital of Treatment (type none if this doesn't apply)
*
Your answer
Medical Expenses
Your answer
Transportation Expenses
Your answer
Tell us about your child or loved one. Name, age, likes/dislikes, siblings, etc.
*
Your answer
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