Therapy Assistance Grant
Fill out the form below and if you are selected a KBK Rep will be in contact with you! If you have any questions feel free to contact is at kokob.kares@gmail.com.
* Indicates required question
Name *
Your answer
Email Address *
Your answer
Do you have insurance *
If so, what is your current Co-Pay?
Your answer
Are you currently enrolled in therapy? *
If so, how long have you been actively enrolled?
Your answer
If not, do you need assistance finding a therapist?
Clear selection
What is your yearly income? *
Your answer
Has your finances beed significantly effected by COVID-19? *
Any additional information that you would like us to know? *
Your answer
If awarded the T.A.P grant, an invoice or receipt of payment will be required from your therapist. *
Submit
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