Grant Application - Ticked Off Lyme Foundation Inc.

Instruction for Application & Submission

Ticked Off Lyme Foundation Inc. is dedicated to supporting individuals in Iowa affected by Lyme disease by providing financial assistance for treatment, testing, and other related expenses. Our grant program is designed to help those who face financial barriers in accessing necessary care.

Please read the application carefully and provide complete and accurate information. Incomplete applications may not be considered.

We will accept applications NO LATER THAN OCT. 10, 2026. Grants will be released mid-November 2026.

Grant recipients will be notified via email, so when applying please provide us with an accurate email address and check your junk email frequently beginning November 15, 2026. ONLY awarded grant recipients will receive an email.

If applying for funds from previous expenses, please provide receipts with your application. Do not go back further than January 1, 2026.

If applying for funds for upcoming appointments, please provide a list of these expenses with date of appointments.

For questions, please contact us at: tickedofflymefoundation@outlook.com

We appreciate your time and look forward to reviewing your application. Thank you for fighting the fight of Lyme disease – WE see you, WE support you, and WE are here to help.

Sincerely,
Ticked Off Lyme Foundation Team

Contact Information

First Name*

Last Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Preferred Contact Method*

Phone

Email

How did you hear about Ticked Off Lyme Foundation Inc.?*

Agreement & Signature

By signing this application, I confirm I have read and understand the entire application form and process. I also confirm all information provided is accurate and complete to the best of my knowledge. I understand that submitting false information may disqualify me from receiving assistance.

I acknowledge that funding is limited, and applications are reviewed based on need, available funds, and alignment with the foundation’s mission.

If awarded a 2026 grant, I will provide all medical/supplement bills to the Ticked O Lyme Foundation in acknowledgement that I am using the funds appropriately.

Applicant Signature

Signature of Guardian

If patient is under the age of 18.

Date

Instruction for Application & Submission

Contact Information

Medical & Financial Need

Supporting Documentation

Agreement & Signature