Request Hospice Support

Interim Healthcare Foundation, Inc. is currently able to support residents of Texas and eastern New Mexico. Please review this information and complete the form on this page to request assistance.

Areas of Support

Interim Healthcare Foundation meets its mission by supporting the following:

  • Financial assistance for terminally ill individuals and their families who are experiencing financial distress and are unable to be self-sufficient due to the circumstances of their terminal diagnosis
  • Grief support groups for family survivors
  • Memorial services
  • Education events that communicate the importance of hospice care to the community
  • Bereavement activities
  • Funeral and burial assistance
  • Caregiver transition
  • Wish fulfillment

Grant Criteria

  • Interim Healthcare Foundation will consider financial requests from any patient who has a terminal diagnosis, regardless of care provider.
  • The application for assistance must include a letter from the applicant’s physician indicating that the applicant has a terminal diagnosis.
  • Interim Healthcare Foundation cannot pay for medical bills that an applicant has accumulated with any health care company. In these cases, if the patient or family meets the criteria of financial distress, a grant request can be submitted for assistance with other living expenses to help alleviate the financial stress.
  • If a grant recipient is residing in a medical facility, financial payments will not be made to the patient, but to the appropriate vendor.
  • Individual & Family Assistance will not be awarded to pay for the following:
    • Credit card payments and fees
    • Personal loans
    • Education loans
    • Medical expenses
    • Life insurance premiums
    • Property taxes
    • Income taxes
    • Legal fees

Contact us and we will be glad to assist you through this process or answer any questions you have.

Name of person requesting support
Contact info
Home Phone
Cell Phone
Email
Address
Street
City
State
Zip Code
Name of person for whom funds are requested
Name of Hospice care provider
Amount ($)
Request
Financial assistance for terminally ill individuals and their families who are experiencing financial distress and are unable to be self-sufficient due to the circumstances of their terminal diagnosis.
Grief support groups for family survivors
Memorial services
Education events that communicate the importance of hospice care to the community
Bereavement activities
Funeral and burial assistance
Caregiver transition
Wish fulfillment of the patient
Other (please specify):