An application and medical release form are necessary before the Island Gift of Life can officially begin to help a patient in need of financial or medically related support.

However it is not necessary to fill out a form if you have questions about whether you would qualify as a patient that we could help. Please contact us and we will help you figure this out.

Download the application packet

If you would like us to mail the packet to you, please let us know and we would be happy to oblige. E-mail us at: