Application

Daquan Q. Johnson Aplastic Anemia Foundation is a 501(c)(3) non-profit organization under the federal tax guide lines that provides financial assistance to families with the life threatening Aplastic Anemia. The funds has a budget of $1000 per family per year for the purpose of providing  financial support to these families to cover costs of medicines not covered by insurance, travel, lodging, and other living expenses for qualified participants. If you are a parent or guardian of a child with Aplastic Anemia, and have been forced to incur significant financial burdens in the process of getting your child the medical treatment they require, you may be eligible to receive financial assistance from the Daquan Q. Johnson Aplastic Anemia. We offer short-term financial assistance to families of children with aplastic anemia, particularly those in the midst of treatment or prolonged hospitalizations. We know what it is like that is why we would like to support families at a time of need.

Daquan Q. Johnson Aplastic Anemia Foundation application for financial assistance will be considered only if completed and submitted by a social worker.


Please click on link for application form and the photo Release form below. Please print the forms. Please be sure it is completed in full.
Then: Scan and email to dqjaplasticanemia@gmail.com or mail to:  

Daquan Q. Johnson Aplastic Anemia Foundation
P.O. Box 11850
Pensacola, FL 32524
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