HELP REQUEST FORM
Help Request Form
Our mission is to provide support to families in the Antelope Valley struggling with the effects of childhood illness and to contribute to pediatric hospitals and charities that make a difference in the community. If your child has a medical condition that would qualify for help, please complete the form and supply the required documents for Cure a Child to evaluate.
*An in-person interview will be required.
*It will also be required to bring the child’s birth certificate at that time.
If you have questions please call or text 661-810-9086.