ALGSAssistance Program

ALGSAssistance

The Alagille Syndrome Alliance considers financial assistance to families with children, youth or adults receiving treatment for Alagille Syndrome. ALGSAssistance should be used as financial help during a time of need but not be counted on in any emergency situations. The ALGSA does not and will not discriminate based on the basis of race, color, religion, gender, age, nationality, disability, marital status, or military status in any of its activities or operations.

ALGSAssistance Guidelines

  • ALGSAssistance is currently available for TWO U.S. families per month at a MAXIMUM of $250 each
  • Once this maximum is met each month, we will no longer be able to fulfill the remaining requests
  • APPLICATIONS FOR ALGSASSISTANCE ACCEPTED the 1st THROUGH the 10th of each month only. Payments will be processed by the 20th of the same month
  • Anyone currently receiving treatment for Alagille Syndrome OR any parent/caregiver of a child currently receiving treatment for Alagille Syndrome may apply  for ALGSAssistance
  • You may apply as many times as needed throughout the year, however, an individual will be awarded ALGSAssistance a maximum of one time per calendar  year
  • The ALGSA makes payments ONLY to third party service providers, and payments may ONLY be sent to U.S. addresses
  • The third party bill(s) MUST accompany this application
  • ALGSAssistance cannot be used for emergency services including utility cut off notices
  • Limit of $250 per application with a maximum of $250 awarded per family, per calendar year
  • Please do not submit bills in excess of $250 unless you have verified with the third party service provider will accept a partial payment
  • A CaringBridge page, other public social media page, letter from physician or case worker on letterhead or a medical eligibility form from the physician will be required for verification (Please email alagille@alagille.org if you need the medical eligibility form)

Examples of Expenses Covered

  • Home: Rent/mortgage or Utilities/electric
  • Vehicle: Car payments or car insurance
  • Medical: Medical expenses not covered by insurance

Please complete this application form to receive consideration for financial assistance. ***NOTE: applications must be submitted between the 1st and 10th of the month to be considered.

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