Jill Fox Memorial Fund Jill Fox Memorial Fund
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The Jill Fox Memorial Fund, Inc. accepts applications from degreed social workers or healthcare professionals (RN, Occupational, Speech or Physical Therapist, Physician, Case Manager, etc.) who advocate on behalf of their clients.  Individuals may not submit applications on their own behalf. 

Upon request, the Jill Fox Memorial Fund, Inc. will mail or fax its 2-page application form to a healthcare professional or social worker that is responsible for completing the application in its entirety. 

The application requires the following information to be provided:

  • Client and Family Profile
  • Medical and/or Healthcare Need (Procedure, Treatment, Equipment or Healthcare Related Services)
  • Amount of Grant Request
  • Vendor Estimates
  • Family Finances
  • Employment History
  • Insurance Coverage
  • Other Funding Sources Contacted
  • Supporting Information
  • Social Worker/Healthcare Professional Contact Information