Social Workers Application


Our mission is to assist single parent families with urgent everyday expenses so that the parent may remain by the child’s
bedside during catastrophic illness.

We encourage the family’s hospital social worker to contact the Foundation directly to apply for assistance directly to us on behalf of the family in need. In this way we are able to minimize time and paperwork, and able to assist in an expeditious turn-around time.

  We welcome requests from social workers from all 50 states on behalf of families who have exhausted all other financial resources.  Our staff will evaluate the family’s case against our criteria and available resources,  and will work with the social worker to develop an assistance plan. 
Please contact our program manager at 310-276-7111 or

To submit a request immediately, social workers may fill out the below Online Request for Assistance form, and submit electronically.

 If you need to for hard copy you may download it via the second link and return it to, or by fax to 301-276-0244.

( to send by mail form or if print out is needed)


Typically payments are used to help families overcome severe financial burdens, thereby ensuring that their sick child has a caregiver by his or her side. 

 ASRL makes payments for housing, transportation, groceries, insurance, phone bills, utilities, sibling needs and other high priority expenses during a medically and financially fragile time. 
Payments are  made directly to the vendor.

Partner Hospitals

ASRL has  worked with over 50 hospitals across the United States to provide assistance on a case-by-case basis for qualifed families.  The Foundation also has provided major grant funding in the past and/or started endowments at the following  partner hospitals so that they can administer their own ASRL family assistance programs:

Akron Children’s Hospital

Boston Children’s Hospital

Children’s Hospital Los Angeles

Children’s Hospital of Philadelphia

The Children’s Inn at NIH

Institute for Families

Lucile Packard Children’s Hospital

Morgan Stanley Children’s Hospital

Sloan Kettering 

Pittsburgh Children’ Hospital

Texas Children’s Hospital

UCLA Mattel Children’s Hospital