The Jason & Tamara Mitchell Foundation -
 
 
PROGRAM SPONSORSHIPS
Health & Wellness Education
End-Stage Renal Disease Assistance Program
Youth Etiquette Education
 
 
 
DIALYSIS PATIENT
NUTRITION ASSISTANCE
 
Program Dates: January 1 through December 31
 
Grant Amount: $125 for food costs
(per household, per year)
 
Open to current dialysis patients
 
Applicants must complete the online information form below to receive an application. The application will be sent to you via U.S. Mail or emailed within 24 hours. Please complete all forms and return with a photocopy of your photo identification. 
 
Approved applicants will be notified by U.S. Mail and/or email.
 
Please complete the fields below.
First Name:
Last Name:
Email:
Phone:
Address 1:
City:
State:
Zip:
 
 
 
 
 
 
 
 
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