Building on Love Screening Questionnaire

Welcome to our Building on Love potential grantee screening questionnaire. To complete the quick questionnaire, just click on the link below and complete the contact form and respond to the questions.  We will be in touch within 24 hours of receipt with an update.

An overview of our giving parameters:

  • The patient named in the application must be a child under the age of 18.
  • The patient named in the application has been recently diagnosed with a life altering illness and is in active treatment. Our goal is to engage with families within 120 days of initial diagnosis.
  • The family must reside, and have maintained uninterrupted residency for 12 months, in one of the counties served by our approved referral partners.
  • The family is facing a demonstrable loss of income due to missed work. Though we do not base our decisions on replacing lost income – our goal is to provide a temporary financial bridge. This focuses our efforts on working families. We also consider any substantial increase in non-medical related expenses due to the qualifying life-altering diagnosis.
  • At the time of the application, the family must be current with their bills. We will consider applications where we help families “catch up” if they recently missed a payment deadline(s), but applications that show families are substantially behind in the bills are typically not approved. Our goal is to keep financially stable families on stable financial footing while they determine the medical needs of their child.
  • With a focus on housing (rent/mortgage payments) we pay bills directly to vendors on behalf of our families.  We do not provide any direct financial support to our families.