Patient Assistance Grant (PAG) Program

This program offers grants to patients with Dravet syndrome and related 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 meet the program requirements. Once funds are depleted for a PAG session, the program closes for the remainder of the year.

 

The program does not cover medical co-pays, therapy costs, respite assistance or service animals.

 

For families applying for an iPad – please note that the PAG program will either cover a 64GB iPad Air 2 or a 64GB iPad mini 3 wifi model.

 

Our 2016 grant cycle will begin on March 1 at 12:01am EST and closes on December 1, or when funds have been depleted for the year, whichever comes first.

 

Application packets must be complete and include supporting documentation before they are placed in queue for review.

 

Applicants will hear back from DSF on the status of their grant request within 45-60 days of submittal.

 

Beginning in 2016, we ask that families only apply once per annual grant cycle. 

 

PAG Overview

PAG Application (fillable form*)

 

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*How to use a fillable form

You must have the free Adobe Reader 8 to take full advantage of the enabled functions such as the ability to save completed forms. You can visit the Adobe website and download Adobe Reader 8 software here

 

After you have entered all of your data in the form, make sure to hit “save” and name your file. You can then email your saved file with supporting documentation to complete the application process. If you prefer to mail your completed application, print a copy of the completed application after you have added all of your data.