Apply for Assistance – Referral Guidelines

To begin the process of initiating a case with the Clayton Dabney Foundation, a licensed representative (caseworker, child life specialist, nurse, or doctor) from a recognized organization or agency (hospital, hospice care, social work, or volunteer group) working directly with the needy family hears or sees the needy situation of the family.

We consider needy families to include, in addition to those who are financially impoverished, those who fall into lower 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.

Screening Criteria

Our screening criteria used in determining need includes:

  • Children 18 years old or younger
  • However, if a child is under the age of 21, was diagnosed before turning 18 and is still being treated in pediatric oncology the case may still qualify for assistance.
  • Case must have progressed to last stage, terminal cancer
  • Family in financial need as validated by the referring organization
  • Recommendation of the representative of the referring organization must be accompanied by medical authorization of the child’s primary physician

Request Guidelines

  • Gifts, last wishes and financial assistance which will facilitate quality of family life and create everlasting memories
  • Generally a $2,000 cap per family
  • For examples of recent CDF cases please read our Family Stories

Application Forms

If you would like to apply for assistance from the Clayton Dabney Foundation, please review our referral guidelines above. The following three forms must then be completed and returned to us for consideration.

If you have any questions about the application process, please feel free to contact us directly.

Clayton Dabney Foundation

Clayton Dabney Foundation