Apply for Assistance

This is a soft place to land. Tell us what your family needs. There is no judgment here — only a desire to help in practical ways.

Assistance Questionnaire

All information is kept confidential and used only to respond to your request.

Your Name *

Email *

Phone

City / Area

Child’s Age

How did you hear about us?

What kind of help would be most meaningful right now?

Sensory tools / equipment Caregiver respite Emotional support / connection Practical resources / guidance Other

Please share a little about your family’s situation *

A few sentences is enough. Write from the heart.

I understand that the foundation will contact me about this request and that my information will be treated with care and confidentiality. *

Your privacy matters. We never sell or share personal information. If you prefer, you can also email us directly at mauricio@stdymphnaautismfoundation.org.

Apply for Assistance

Application Received

Assistance Questionnaire