The Island Gift of Life Foundation
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APPLICATION FORMS

An application and medical release form are necessary before the Island Gift of Life can officially begin to help a patient in need of financial or medically related support.

However it is not necessary to fill out a form if you have questions about whether you would qualify as a patient that we could help. Please contact us and we will help you figure this out.

Download the application

Download medical release

If you would like us to mail the forms to you, please let us know and we would be happy to oblige.

 

contact us | e-mail

PO Box 532, Shelter Island Heights, NY 11965