The DSF Patient Assistance Grant Program offers grants to patients with Dravet syndrome and related SCN1A epilepsies for necessary medical equipment, therapy devices, and educational aids associated with these conditions that are not covered through private insurance or other assistance programs. This program is open to all patients worldwide who are members of the DSF Family Network.
Our grant application period runs from January 1st – November 30th each year. We cannot accept applications during the month of December. If funds are depleted for the year, the program will be closed until the next application cycle and notification will be placed on our website. Any remaining funds are rolled over, with the program re-opening each year on January 1st.
Applications will be reviewed and approved on a first-come, first-served basis. An applicant may apply once per grant cycle with a yearly maximum of $1,500 and a life-time award maximum of $5,000.
Your application packet should include the following documentation:
- Completed application
- A recent letter from the child’s physician or health care professional, on their letterhead, explaining the medical necessity of your request, as well as your child’s diagnosis of Dravet syndrome or related SCN1A epilepsy.
- A letter of denial from the insurance provider stating that the requested equipment and/or service was denied (when possible)
- A W2 or other form of ID that verifies your identity (with SS# information redacted)
- Any other documentation pertaining to the nature of your request (all information is kept confidential)
- Please DO NOT submit personal medical records, such as a genetic testing report or medical charts
Applications that are incomplete or missing requested additional information will not be placed in queue for review until complete. Incomplete applications expire after 60 days. All applicants will receive an email stating approval or denial of their application. Denied applicants wishing to re-apply must provide additional documentation of a change of status in circumstances or that other alternatives have failed. We request up to 45 days to review your application. You can submit your application online below, or a printable application is available in English and Español. Please email Karen with any questions.
Familias de habla hispana: si necesita ayuda con el Programa de subvenciones de asistencia al paciente, envíe un correo electrónico a gloria@dravetfoundation.org. Haga clic aquí y revise los artículos calificados antes de enviar una solicitud.
Application for Caregivers
Application for HCPs
Application for Caregivers
Your application packet should include the following documentation:
- Completed application.
- A recent letter from the child’s physician or health care professional explaining the medical necessity of your request. The request must be on the physician’s letterhead and should include the patient’s diagnosis of Dravet syndrome or related SCN1A epilepsy.
- A letter of denial from the insurance provider stating that the requested equipment and/or service was denied, if applicable. Not required for cooling vest, iPad, or seizure monitors (excluding Embrace2).
- A W2 or other form of ID that verifies your identity (with SS# information redacted)
- Any other documentation pertaining to the nature of your request (all information is kept confidential).
- For questions or assistance, please email us.
The information collected by Dravet Syndrome Foundation will not be sold or distributed outside of DSF and is used solely to verify identity and assist with communication. Questions or concerns can be directed to our team.
