Support Application

The information on this form will be used only in the selection process to be considered for the Icon Therapy Fund by the Icon Project’s staff only and our therapy partners.

We look forward to helping you with having access to therapy. Please fill out the following information so we can confirm your eligibility. Once you apply, we evaluate your application and reply within three weeks.

The Icon Therapy Fund applications are limited opportunities. Completing the application does not guarantee of selection.