Weight Loss Surgery Foundation of America

Saving lives one grant at a time

How To Apply For A Grant

Referrals and Grant Applications accepted from June 1, 2014 – December 31, 2014

If you have been medically approved for weight loss surgery or reconstructive plastic surgery after weight loss surgery and have been denied surgery for financial reasons you might be eligible to apply for a grant from the Weight Loss Surgery Foundation of America.

IF YOU HAVE A QUALIFIED SURGEON
Step 1) To apply for a WLSFA Grant you must be referred to the WLSFA Grant Program by your qualified surgeon via our on-line form.
Step 2) Once referred you may submit an application to the WLSFA Grant Program via US Mail by 12/31/2014
Please note: A written referral letter from the surgeons office is not accepted.

IF YOU DO NOT YET HAVE A QUALIFIED SURGEON WHO CAN REFER
Locate a local surgeon and ask if they are familiar with the WLSFA Grant Program
If you are looking for a bariatric weight loss surgeon you can SEARCH HERE to locate a provider by your zip code.
If you are searching for a reconstructive plastic surgeon you can SEARCH HERE to locate a provider.
Please Note: Not all surgeons are aware of the WLSFA or our grant program.

WHO IS A QUALIFIED SURGEON?
They are members of the WLSFA Network of Care VIEW NETWORK OF CARE MEMBER LIST
Click to read complete qualification details for surgeons

IMPORTANT INFORMATION ABOUT BEING REFERRED
Email Us if you are not sure your surgeon is qualified to refer or you do not yet have a surgeon.

If you have already been referred: Access the application forms and information HERE

INFORMATION FOR MEDICAL PROFESSIONALS
If you are a qualified surgeons office: Please Send an email to request a password and link to the referral form. Referring offices will be required to print a copy of the referral form to give to your patient.

To Help You Prepare

All referred applicants must be in the United States and 18 years old or older. You will be asked to provide the following required information with their grant application:

· A letter of referral from your surgeons office via the WLSFA Online Referral Form

· Completed Application Forms

· Completed Financial Questionnaire

· If Insured: Verification of insurance denial – including appeal

· Verification of personal loan denial from three different sources

· Verification of public assistance denial ( Medicaid, Medicare, State Programs) (If quailified for these programs)

· Contact information for two character references ( Name, Phone, Email Address) – Not family members

All applicants must answer the following questions:

· Agree to raise 10% of the funds required for your grant. (The WLSFA will assist in the fundraiser)

· Willing to be an Ambassador for the WLSFA – Appear on Television, Radio, Print and On -Line

· For Weight Loss Surgery Only – Agree to attend support group provided or recommended by your surgeon for one year

The Selection Process:

The selection committee bases it’s decisions on financial hardship and patient effort only.

All required information must be submitted with the application including an essay. The essay can be up to five type written pages telling your story. This essay helps the selection committee determine who is most deserving. The Blinded grant application (the applicants name and contact information is removed) along with the surgeons referral is reviewed by the selection committee who selects the finalists. The board of directors of the WLSFA choose the actual grant recipients from the finalists for each grant cycle. The number of grants awarded is based on the funds raised in that grant cycle. There is no guarantee any grants will be awarded.

Questions: email us at info@wlsfa.org
Call us at 415-234-9074 M-F 8 – 5 PM PST

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