Refer A Patient

PATIENT APPLICATION If you know a patient or you yourself would like to be considered for possible life altering surgical treatment, please read the following questions carefully before submitting the necessary application (MSWord or PDF)
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What types of patients qualify?

Any patient with a physical deformity that requires a reconstructive surgery, regardless of race, age, gender, or place of birth will qualify to be evaluated by the foundation. These deformities may be congenital in nature or post-traumatic.Typically these patients lack the necessary funds to pay for quality healthcare, or they come from developing countries that do not have access to medical care.

What is the process of selection involved?

To be selected, each patient will submit an online application to be reviewed by the committee. A predetermined committee formed by a physician and medical providers will review the patient’s application, including a detailed medical history and medical records. Once determined that a patient qualifies for a reconstructive surgery, the patient will be selected to receive a full comprehensive, in person or virtual consultation, with an assigned qualified reconstructive surgeon or reconstructive surgical team. A surgical plan will be determined by the reconstructive surgeon assigned to the case, who at that point will make the diagnosis and outline the necessary procedure(s).

Once the cost of each surgery is determined, the patient will be given his or her own home page within the umbrella of This page will be personalized and individualized to each patient. It will include detailed information about the patient, including their age and medical diagnosis. There may also be a small 2-minute reel of interviewed videos. The purpose of this page is for the patient to have the opportunity to tell their story, to describe how their disease has affected their day-to-day life.

How long does it take before I am informed about the acceptance of the application?

Once the completed application is submitted to the foundation and reviewed by the committee, the patient will be notified within 1-4 weeks regarding the status of the application. Please remember that the completed application may include previous medical and surgical records and imaging studies, such as CT scans or MRIs.

Can I help with raising money for my surgery?

The foundation encourages each patient and their friends and family to be the advocate of the patient. By means of community events and fundraisers (ie. 5K run/walk, community car wash, silent auctions, etc.), they can raise awareness for their specific cause and direct potential donors to the website. The foundation will be available to assist in the organization of these events.