Health Missions | Healthcare. Education. Research.

Chirokids

Healthcare Fund

Support Natural Healthcare for the disadvantaged.

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Paper Fund Application

To read about others who have been helped by the Chirokids Healthcare Fund click here.

Do you know a child that has been suffering from a condition that they have not been able to get results from with conventional medical care? Are you ready to try a natural and effective means of health and healing? If so, you may qualify for a Chiro Kids Healthcare Fund. This fund includes the cost of care for your child, including chiropractic, nutritional therapy and functional rehabilitation. The fund will also include airfare for the child and a parent and lodging for 1 month to receive care.

To apply for the fund please complete the online form below. Or you can print a paper copy and mail it to Health Missions at the address provided on the form.

You may also contact Health Missions directly via email:

info@healthmissions.com

Chiro Kids Healthcare Fund Application

	Child Information
	Child's Name:
	Age:	Gender: Male Female
	Address:
	City:	State: Zip:
	Parent / Guardian Information
	Name:
	Age:	Gender: Male Female
	Address:
	City:	State: Zip:
	Phone Number:
	Email:
	Background Information
	Current condition Child is suffering from
	Detailed Explanation of Medical History (include medications, diagnostic tests, surgeries, etc.) :
	Why should you or your child be picked to receive the Chiro Kid’s Healthcare Fund?
	By checking this box, I understand that the natural healthcare services I will potentially receive are not designed to treat disease. Regardless of the name of the disease they will not treat it. The only goal is to assist my body with its inborn potential to heal itself. Although Health Missions, LLC will need to know the conditions that I am suffering from they will not treat the condition.
	By checking this box, I understand that Health Missions, LLC does not advise you to stop the current treatment you are receiving. They will focus on the integration of natural healthcare services to assist in your overall recovery.
	Please enter today's date to help confirm your application and understanding of the terms of the scholarship: