Application for Services
Help A Diabetic Child (HADC)
Please complete the form below to begin the application process.
Our team will review your information and find out if we have additional questions to see if you qualify for our HADC program.
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Every Dollar Keeps A Child Alive
Your donation provides life-saving insulin, supplies and access to care.
$50
Provides emergency Supplies
$100
Supports one month of insulin
$250
Provides CGM assistance
$25
Choose your own amount
$25
Provides glucose test strips