INFORMATION/CONTACT US:

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 disentangleAD, c/o Memory Center

415 South 28th Ave, Hattiesburg, MS 39401

Phone: 601.579.5016

Email: info@disentangleAD.com

or use the contact form below

NEW APPLICATIONS CURRENTLY BEING ACCEPTED

 

APPLICATION INSTRUCTIONS

 

DEFINITIONS:

For purposes of this application, a caregiver applying for the mini-grant will be considered the “applicant.” As funding is intended to help with caring for someone with Alzheimer’s disease (or related dementia), the patient will be considered the “recipient.”

 

FUNDING:

Mini-grants are typically limited in range, $250-$1000 per request.

 

RECOMMENDED GRANT REQUESTS*:

Below are representative examples of targeted funding priorities (alternative requests of a similar nature may also be considered): •  Small scope home renovations (e.g. door locks, alarms, ramps) •  Time-limited respite, home care, or counseling •  Transportation grants (caregiver or patient travel)

 

REQUIRED DOCUMENTATION:

1. Contact information for applicant (Pine Belt resident)

2. Contact information for recipient (if different from applicant)

3. Physician letter or medical record documenting dementia diagnosis (recipient)

4. Brief description of mini-grant request (what the funds will be used for)

5. Estimated cost of the project or service

 

 

GRANT APPLICATION FORM:

 

 

The application is available via PDF file. Complete and SIGN the form.

Remember to include the required supplemental documentation (see above). Grant application may be sent in via regular mail or email. For questions, our contact information and mailing address is listed at the bottom of this page.

 

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FREQUENTLY ASKED QUESTIONS

 

Can the grant applicant reside elsewhere if the recipient resides within the Pine Belt region?

Yes; as long as the project or services are delivered within our region.

 

Is a doctor letter or copy of a medical record really necessary?

Yes; the fund is obligated to verify that grant recipient does have a dementia syndrome and that the grant request directly relates to the care associated with that diagnosis.

 

What is considered acceptable documentation to verify diagnosis?

A simple letter from your doctor stating that recipient has a dementia diagnosis. Alternative documents may include a hospital discharge summary or a copy of an office note/visit.

 

When will I know if my application has been accepted and when will I receive the money?

 

 

All applications go through a thorough review process. You will be contacted by our grants committee. Applicants will not directly receive the funds. Grants are distributed throughout the year.

 

Who is going to complete my project or service request?    

We can assist with vendor recommendations for service requests.

 

How can someone donate to disentangleAD?

Make check payable to The Greater Pinebelt Community Foundation (include disentangleAD on the memo line).

 

Send to:  GPCF, 1501 Adeline Street, Hattiesburg, MS 39401.

 

For questions regarding GPCF call 601-583-6180, or visit pinebeltfoundation.org.

 

*Is anything not covered by this type of grant?

Grant requests for medical expenses, prescriptions, or medical equipment (e.g. wheelchairs, hospital beds) will typically not be considered for funding