Suzy Foundation

A non-profit organization dedicated to helping individuals with the cost of assistive equipment not covered by insurance.

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2020 Application for Assistance

To Qualify YOU MUST:

  • Include a letter or prescription from the applicant’s doctor confirming the need for the requested assistive device or therapy.
  • Include a copy of parent(s)/guardian(s) most recent Income Tax Return (IRS Form 1040) with copies of all supporting W-2 forms. For your security all information is confidential and treated with the utmost sensitivity. Please black out your social security number. All documents will be shredded once a decision has been made.
  • Include a letter of denial from parent(s)/guardian(s)
    insurance company.
  • Live within Arizona

Please be advised that the Suzy Foundation will directly purchase the assistive device or therapy for the applicant. Suzy Foundation will NOT reimburse services rendered or devices previously purchased. Please include all of the necessary purchasing information. Please use the form below to apply for Suzy Foundation assistance. Once you complete the form, you can upload your application files here. Please label your folder with YourName_Date and zip all files before you upload. If you need technical assistance please call us or send us an email.

Please label your files with the name of the Applicant and the Document Name : Example – prescription would be labeled: ApplicantName_Prescription.doc

    *If the applicant receives OT, PT, or speech therapy, and the device or service you are requesting will improve his or her progress within that therapy: Please attach a letter from the applicant’s therapist detailing your child’s current limitations and progress.

    **If not covered by your insurance, please attach an official letter of denial from
    your insurance provider at the end where you upload files.

    SHOW YOUR SUPPORT

    • Donation to Suzy Foundation $100.00
    • Donation to Suzy Foundation $25.00
    • Donation to Suzy Foundation $50.00

    Our Impact

    We are dedicated to helping individuals with the cost of assistive equipment not covered by insurance. Suzy Foundation is a 501(c)3 non-profit organization, your donations are 100% tax deductible.

    REACH US

    Email: suzyfoundation@gmail.com
    Phone: (602) 803-0137
    Mail: Suzy Foundation
    P.O Box 24877
    Tempe, AZ 85285

    Who We Are

    We are mothers, fathers, grandparents, friends, neighbors, and community members who want to make a difference to enrich the lives of individuals with special needs. Our hope is that all people may have the same opportunities despite challenges and disabilities.

    What We Do

    We are dedicated to helping individuals with the cost of assistive equipment not covered by insurance.

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