The Foundation can provide support to your family by assisting with the costs of temporary housing near the pediatric facility where your child is being treated.

In Oregon, the Foundation makes Elijah’s Heart House available as a family retreat for a peaceful respite.

Support

Elijah’s Heart House can help families in one of these three ways:

Assist with costs across the United States.
Provide temporary housing in Oregon.
Offer Elijah’s Heart House retreat.

Details

Social Workers or Medical Professionals can apply for a grant.

Applicants must provide at least one of the following*:

Consultation Note
Physician/Provider Letter.
FMLA Letter.
Receipts for housing/lodging
EHH will respond within 24-72 hours if your application is pre-approved.

*Please have your documentation and information ready before you begin your application.

GRANT APPLICATION

You must fill out the form completely and submit documentation for your application to be considered for pre-approval.

The foundation gifts grants, after we have reviewed and spoken with the family prior to or during the hospital stay. Each application will be reviewed and a specific amount granted according to the needs of the family.

APPLICANT INFORMATION

What is your relationship to the patient?

Parent/Family Member

Physician

Social Worker

How can we support you? *

Costs across the United States

Temporary Housing in Oregon

EHH Retreat Home

PATIENT INFORMATION

Patient Name *

First Name

Last Name

Patients Age

Guardian Name *

First Name

Last Name

Current Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email *

Phone *

(###)

###

####

REASON FOR FUND REQUEST

Type of medical procedure *

Please share a brief description of the medical procedures you are facing

Date of Procedure *

YYYY

Procedure Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Estimated timeframe for recovery *

Location of recovery for patient/family *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

PHYSICIAN INFORMATION

Physician's Name *

First Name

Last Name

Provide Physician Statement/Documentation *

Once you receive an email confirmation, please reply and attach your documentation.

I have documentation.

I do not have documentation.

Additional Information

Include any additional information you feel would be relevant or you would like us to consider.

Photo Release

We would be honored if you would take pictures of your family during your stay and either email them or text them to us. Our Elijah Heart House donors love meeting the families who stay at the house. We would share the photos on social media and through our newsletter to update our donors.

Yes

Thank you for taking the time to give us information about your request.

NEXT STEP, PLEASE EMAIL YOUR DOCUMENTATION TO:

info@elijahshearthouse.org

DOCUMENTATION REQUIRED:

Airbnb, VRBO, hotel receipts
Physician Statement/Documentation

We will review your application and contact you as soon as possible.

Sincerely,

The Elijah J. Auxier Foundation

CONNECT WITH US

PO Box 144, Aurora, OR 97002
971-412-8068 | info@elijahshearthouse.org

ELIJAH J. AUXIER FOUNDATION

501(c)(3) Community Foundation

Join us to receive updates and information as we assist pediatric families in beginning their complex journey.

Email Address

We will respect your privacy.

Thank you for partnering with us to bring compassion, support, and provision to families experiencing the unimaginable.

With love,

The Elijah J. Auxier Foundation Team