Contact information
Name, address, phone number, email address, and parent or guardian information when applicable.

Individual Assistance Program
Review the information below before opening the application. This will help you understand what the Foundation may consider and what documents may be needed.
Before you start
The application is for an individual requesting limited help through the Individual Assistance Program. A parent or legal guardian should complete the application for a minor.
Before applying, please confirm that:
Name, address, phone number, email address, and parent or guardian information when applicable.
A short, clear description of the item, repair, bill, or rehabilitation expense being requested.
Medical confirmation plus an itemized quote, estimate, invoice, or statement from a qualified vendor or provider.
A brief explanation of why assistance is needed and whether insurance, another program, or fundraising may cover part of the cost.
The Foundation checks whether the required sections and documents are complete.
We may contact you for clarification, missing documents, or permission to verify information with a vendor or provider.
The Foundation considers eligibility, program fit, documentation, other available resources, and current funding.
We aim to send an initial response within 3–5 business days after the application is complete. A final decision may take longer.
Ready to apply?
The application opens in a Foundation-managed Google Form. Please answer only the requested questions and follow the instructions for any supporting documents.
Protect your privacy: Do not submit Social Security numbers, bank-account details, passwords, insurance identification numbers, detailed medical histories, or complete medical records unless the Foundation later provides specific secure instructions.
Nathan Powell Foundation does not provide emergency medical services or immediate emergency funding. If you have a medical emergency, call 911 or contact an appropriate healthcare professional. For urgent local needs, you may also contact 211 or another community resource.