Assistance Programs

Request Assistance

Anchored Hearts Foundation offers two assistance programs. Select the application that fits your situation below.

Request or Send a Care Kit

A small act of kindness can make a difficult day a little easier.

Whether you're requesting a care kit for yourself or nominating someone you care about, we're here to help. Our care kits are thoughtfully assembled to provide comfort, encouragement, and practical support for individuals and families experiencing medical hardship.

Please complete the form below with as much information as possible. A member of the Anchored Hearts Foundation team will review your request and contact you if additional information is needed.

Please Note:

  • Submitting a request does not guarantee a care kit.
  • Care kits are distributed based on available funding, donations, inventory, and eligibility.
  • All information provided will be kept confidential and used only to process your request.

Contact Information

Preferred Method of Contact

Care Kit Recipient Information

Who is this request for?
Recipient Age Range

About Your Request

Is this request related to a medical hardship?

(Please do not include detailed medical records or private health information.)

Care Kit Preferences

Are there any specific needs or preferences we should know about?

Delivery Information

Preferred Delivery Method

Additional Information

Thank you for allowing Anchored Hearts Foundation to be part of your journey. We are honored to provide hope, comfort, and support when it's needed most.

Agreement