Emergency Fund Application
Families served by CCL with an Application for Family Services on file whose child is actively in treatment are eligible to apply.
Please upload the following supporting documentation along with your application:
A letter verifying your child’s treatment status. (This can be from a physician, social worker, care coordinator, or visiting nurse.)
A copy of the bill you are requesting the Lifeline consider for payment.
The Lifeline considers these requests on an ongoing basis. Applications with missing information will not be considered. The amounts allotted are at the discretion of the Board of Directors. As a general rule, all bills are paid directly; families are not reimbursed. Availability of funding, as well as access to other supports will be factors in the determination. All decisions are final.
Note: Our forms are HIPAA-compliant and your information is kept confidential.