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Support for Families

We're here to help you on your journey.

From the moment of diagnosis through treatment and beyond, the Pediatric Brain Tumor Foundation community is here for your family every step of the way. Here you'll find resources and support for pediatric brain tumor patients and survivors, their parents, caregivers, and siblings.

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- Emergency Financial Assistance Fund
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Application for Butterfly Fund Support

The Pediatric Brain Tumor Foundation works directly with medical personnel at The Butterfly Fund® partner hospitals to support families who are experiencing financial hardship as the result of a child’s pediatric brain or spinal cord tumor diagnosis. The following application form is only to be used by PBTF staff and social workers at these partner hospitals.

Learn more about the Pediatric Brain Tumor Foundation’s The Butterfly Fund, funding guidelines, and our partner hospital network here. If you are a family in need of support or a social worker with questions regarding The Butterfly Fund application process, please email [email protected].

Who is Completing this Form?(Required)

Name of Person Completing Form(Required)

Email(Required)

Parent/Caregiver's Full Name(Required)

First Name Last Name

Parent/Caregiver's Primary Language(Required)

Parent/Caregiver's Address(Required)

Address Line 1 Address Line 2 City State ZIP code

Parent/Caregiver's Email Address(Required)

Parent/Caregiver's Phone Number(Required)

Patient Child Information

Patient Child Full Name(Required)

First Name Last Name

Race/Ethnicity(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Is the Patient Still Living?(Required)

Patient's Date of Death(Required)

MM slash DD slash YYYY

Type of Brain/CNS Tumor(Required)

Date of Diagnosis(Required)

MM slash DD slash YYYY

Hospital where Patient/Child is treated(Required)

Hospital Name(Required)

Primary Social Worker(Required)

Primary Social Worker's Email Address(Required)

The requested funding assists the family with:(Required)

Housing

Utilities

Car payment/insurance

Travel

Grocery Gift Card

Gas Gift Card

Funeral

Counseling

Amount for requested gift card:(Required)

Up to $300 total per application

Bill Upload 1

Max. file size: 50 MB.

Bill Upload 2

Max. file size: 50 MB.

Bill Upload 3

Max. file size: 50 MB.

Bill Upload 4

Max. file size: 50 MB.

Bill Upload 5

Max. file size: 50 MB.

Additional notes on the application and/or family for consideration:(Required)

Please check any of the ways listed below that the PBTF can be of help to the family(Required)

Please send a Starfolio Resource Notebook for newly diagnosed families

Please send a Survivorship Resource Notebook for families after treatment ends

Please contact the family to share additional resources

No follow up needed at this time

The above patient family would like to receive future communications from the Pediatric Brain Tumor Foundation.(Required)

By selecting 'Yes' and submitting this form, I am confirming that the parent/caregiver above is 18 years of age or older and wants to opt in to receiving future communications from the Pediatric Brain Tumor Foundation. Terms and privacy policy apply: curethekids.org/privacy.

Stay in the know.

Name(Required)

First Name* Last Name*

Email Address(Required)

Name

This field is for validation purposes and should be left unchanged.

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Newly Diagnosed[1]
Life After a Brain Tumor Diagnosis[7]
Support for Families[14]
Research[25]
Get Involved[32]
Donate[39]

About Us[1]
Contact[2]
Updates[3]
Stories[4]
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