Adult Small Gift Requests
When submitting your applications please follow the detailed instructions outlined below.
This is the only way to ensure your application is reviewed and processed.
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Before completing the application please review the following guidelines:
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If you have access to Docusign, it may be used to obtain the required signatures. However, the instructions below MUST be followed!
Please follow the steps below to submit a Small Gift Application
* Applications must be submitted by a member of the patient's hospice or palliative care team.
** NOTE: We do NOT provide reimbursement for payments already made or items purchased
** The bill or invoice must be in the adult patient's name for which the relief fund is being rewarded.
1. Download and complete the application:
2. Once all required information is obtained, please submit the the application and other documents by emailing them in PDF form to info@hpcfoundation.org:
4. Please provide feedback for us to use for marketing purposes:
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If you require additional assistance please reach out to us by calling 855-219-1648 or by emailing us at info@hpcfoundation.org.
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