APPLICATION REQUIREMENTS AND GUIDELINES
The ELLE FOUNDATION INC. is a non-profit organization whose mission is to create memories of joy for children diagnosed with cancer & granting final second wishes for children battling a recurrence of cancer. The ELLE FOUNDATION is not affiliated with any other organization having similar objectives.
- Applications will only be accepted for children diagnosed with a recurrence of cancer. Applicants must be 18 years old or younger and be under the care of a Pediatric Oncologist. (If exceptional medical circumstances exist for children not within this age group – please contact the foundation)
- Wish Child & Family must reside in the United States.
- The child applying for the wish must have finished all forms of treatment and been in remission for at least 24 months for their first diagnosis. The Elle Foundation will exercise its limited discretion to grant a final wish within a shorter period when exceptional medical circumstances exist.
- The child applying for the wish must have had a first wish granted and completed no less than 24 months (2 years) prior to applying for a final wish, written documentation is required. The Elle Foundation will exercise its limited discretion to grant a final wish within a shorter period when exceptional medical circumstances exist (no less than 1 year will be considered).
- A detailed description of the final wish and why it is being requested must be included on the Wish Application.
- Why the ELLE Foundation's mission is important to this child must also be included.
- The ELLE Foundation will not grant a second wish for the same experience or travel/destination as the child’s first wish.
- We do not grant wishes for travel outside the continental United States. (Wishes to Hawaii or Alaska will not be granted).
- Travel wishes are for 7 days/6 nights.
- In cases of guardianship, proper documentation must be submitted to the Elle Foundation.
- Wishes are for immediate family only, two parents, wish child and siblings. Travel wish expenses are only covered for siblings 21 and under that live at home.
- A nurse may be included only if a physician deems it medically necessary.
- All expenditures must be made directly by the ELLE FOUNDATION; consequently, the ELLE FOUNDATION cannot accept an application where parents or guardians for a child’s wish have already expended funds.
- The ELLE FOUNDATION INC. is not responsible for any medical expenses that may be incurred during the wish. These expenses include but are not limited to ambulance transfers, hospital stays, and medical transfers back to the wish child’s home. In the case of death, the ELLE FOUNDATION INC is not responsible for the cost of transferring the remains back to the wish child’s home.
- The ORIGINAL Wish Application and the Physician's Information Form must be completed and returned to the ELLE FOUNDATION’S office by mail. The Release and Indemnification Form must be signed, witnessed and mailed with the completed applications.A current photo of the Wish Child must be submitted with the application (high resolution jpeg format).
- HIPAA NOTICE: - The United States Congress recently enacted the Health Insurance Portability and Accountability Act (HIPAA), which took effect on April 14, 2003. HIPAA was designed to protect patients’ medical records and other health information provided to health plans, doctors, hospitals and other health care providers. In order to comply with this federal law, The ELLE FOUNDATION, Inc. now requires that the parent/legal guardian sign and return the HIPAA Form in order to process the wish application. The physician’s application requires a response from the wish applicant’s treating physician. The physician should require the wish applicant’s parents/legal guardian to complete and sign a HIPAA form during the treatment process.
- Please ensure, before returning the physician’s portion of your application, that signed copy of the HIPAA form accompanies this document. If a HIPAA form has not yet been completed, please call the treatment facility and request one.
- Please note: the wish application cannot be processed without the signed HIPAA form & Current Photo.