Thank you for your interest in the Fragile Kids Foundation. The Foundation is a nonprofit organization that provides key pieces of
equipment not covered by private or government sponsored insurance. The equipment must be deemed medically necessary to
meet rehabilitation and quality-of-life goals. The Foundation has two programs to support our mission, the Healthcare Grants
Program and the Loaned Equipment Program.
You may access our applications online to print them out. We have three (3) types of applications. Please choose application that
applies to your need.
equipment not covered by private or government sponsored insurance. The equipment must be deemed medically necessary to
meet rehabilitation and quality-of-life goals. The Foundation has two programs to support our mission, the Healthcare Grants
Program and the Loaned Equipment Program.
You may access our applications online to print them out. We have three (3) types of applications. Please choose application that
applies to your need.
FORMS
Application
Neccessity
Consent
Wheelchair Lift
All-terrain
LE contract
Vendors
Fragile Kids Foundation
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Applications
1. General Grant Application - used for both Healthcare Grants and Loaned Equipment; the
Letter of Medical Necessity and Consent to Release Information forms must be included
for consideration. If applying for Loaned Equipment, also include a signed copy of the LE
Contract.
2. Wheelchair Lift Application - which is filled out in addition to the General Grant. A list of
wheelchair lift vendors in Georgia is provided for your reference.
3. All-Terrain Wheelchair Application Reservation (Loaned Equipment)
A family may receive one (1) Healthcare Grant item and two (2) Loaned Equipment items per
year.
Include with your application(s):
• a copy of your child’s Social Security card or Birth Certificate
• a denial letter from your insurance company (only when requesting equipment to be
purchased)
• a cost quote and brochure (when applicable) of the item(s) being requested
Mail forms and supporting documents to:
Fragile Kids Foundation
3350 Riverwood Parkway; Suite 1400
Atlanta, Georgia 30339.
The deadlines for applications for quarterly review meetings are as follows: March 31, June 30,
September 30, and December 31.
Letter of Medical Necessity and Consent to Release Information forms must be included
for consideration. If applying for Loaned Equipment, also include a signed copy of the LE
Contract.
2. Wheelchair Lift Application - which is filled out in addition to the General Grant. A list of
wheelchair lift vendors in Georgia is provided for your reference.
3. All-Terrain Wheelchair Application Reservation (Loaned Equipment)
A family may receive one (1) Healthcare Grant item and two (2) Loaned Equipment items per
year.
Include with your application(s):
• a copy of your child’s Social Security card or Birth Certificate
• a denial letter from your insurance company (only when requesting equipment to be
purchased)
• a cost quote and brochure (when applicable) of the item(s) being requested
Mail forms and supporting documents to:
Fragile Kids Foundation
3350 Riverwood Parkway; Suite 1400
Atlanta, Georgia 30339.
The deadlines for applications for quarterly review meetings are as follows: March 31, June 30,
September 30, and December 31.