Hope Chest Go - English
Welcome to Hope Chest GO!
Please read the following paragraph before completing the application:
- This application should take you between 5-10 minutes to complete.
- Grant applications are considered and processed pursuant to Hope Chest Go’s Support Guidelines, which are available via this link.
- Please have the first and last name, email address, and phone number of your Social Worker, Nurse Navigator, or Doctor. They will need to verify treatment before your grant application can be approved. You must send this form to one of the people mentioned above. If you send it to yourself or someone else, this will delay getting assistance.
- Grants are generally paid directly to the company owed. Please have the name, your account number, and the address of the company owed ready.
- You will need to provide a copy of the bill(s) you wish to be paid with this application.
The application has an auto-save feature and will save a Draft after answering a question, and you can return to their drafts. All questions are required unless otherwise indicated.
If you have any questions regarding the form or the questions on the form, please contact Robin Chambers at rchambers@hopechest.com
If you run into any technical issues please use the following link to contact Submittable Technical Support