To begin the process of initiating a case with Clayton Dabney for Kids with Cancer, please read the following criteria to make sure the patient meets our criteria. If you have any questions, please contact our Program Director, Lauren Cockrill at 214-361-2600 or lauren@claytondabney.org.

We consider needy families to include , in addition to those who are financially impoverished, those who fall into lower to middle income brackets where both parents are working though unable to take time off because they are working so hard to cover all of the family expenses and medical bills. Cases must also meet additional criteria as outlined below.

Clayton Dabney’s criteria for request approval includes:

  • Patient must be diagnosed with a cancer or cancer related illness.
  • Patient must be terminal and in the last stages of their illness.
  • Patient must be 18 years old or younger (however, if child is 21 or younger and was diagnosed with their cancer before turning 18 and is still being treated in a pediatric facility, the patient may still qualify)
  • Family must qualify as low income or financially needy PRIOR to diagnosis. This should be determined by referring hospital or hospice care team before submitting request. Questions on this should be directed to Lauren Cockrill.
  • Patient must be referred by a hospital or hospice care facility. Families of the patient cannot submit an application.

Request Guidelines

    • Gifts, last wishes and financial assistance which will facilitate quality of family life and create everlasting memories
    • A $2,000 cap per family
  • For examples of recent CDF cases please read our Family Stories
  • Clayton Dabney does not assist with medical bills or funeral related expenses.

APPLICATION FORMS

If you would like to submit an application for assistance from Clayton Dabney for Kids with Cancer, please review our referral guidelines and fill out the forms below in full. You may fax your completed forms to 1-888-374-0131.

If you have any questions about the application process, please feel free to contact Lauren Cockrill at 214-361-2600 or lauren@claytondabney.org.