Apply

FREE Care Package

Are you someone who could benefit from an iHeal Care Package but simply cannot afford one?
Below is an application form we encourage you to fill out and submit. Because of the many requests, we cannot provide packages to everyone but we do our best to assess each need. Because our organization is small, applications are reviewed every few months and care packages are issued based on the amount of donations collected in the interim, the assessed needs, and the order of receipt. Approved applications will receive a congratulatory email requesting confirmation of their mailing address.

Should you know someone who could benefit from a subsidized package and you cannot afford to sponsor one for them, please direct them to this page which is: www.ihealcare.org/apply
At this time, we can only receive applications from individuals themselves who have the illness
because of our need to respect privacy policies.

Application for FREE Care Packages

* Indicates required field

As the applicant, are you currently suffering from either cancer or diabetes? *

Yes No

If you are currently on a cancer journey, please name which cancer you are suffering from? *

Which care package are you interested in receiving? *

Please describe why your application should be considered above less pressing ones. *

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

By submitting your application, you agree to have your name published as one of the individuals who received a free care package. You also agree for an iHeal representative to contact you should there be a need for additional information or clarification in regards to your application.

Submit