Applying for a Lyme Treatment Foundation Grant

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 You will need to upload a physician's note stating your diagnosis. We accept letters from MD's, DO's, ND's, etc. 

This letter must be on an official doctor's letterhead with the physician's name and phone number. 

You may also upload a positive Lyme disease/tick-borne illness blood test in place of a physician’s letter.

If you do not have a diagnosis yet, visit the link below. 

Canada Applicants

Submit their T1 General Tax form for income verification purposes

UK Applicants

Submit their SA100 Tax Return to verify income

Germany Applicants

Submit your Einkommensteuererklärun Tax Return to verify income 

Ireland Applicants

Submit your Form 11 Tax Return

U.S. Applicants

 Upload the first page of your 1040 Federal Tax return

**Please block out any sensitive information, such as your social security number on your tax document to ensure your privacy is protected.

Share why a grant from the Lyme Treatment Foundation would help you. Share your story, along with your symptoms and other pertinent information that can help our grant committee understand your needs. 

All information provided is completely confidential and will never be shared without your written consent.

You can either upload a word document or write directly into the box provided on the application on our website. 

 Upload a letter of support from family or members in your community who know you and your Lyme disease situation best.

The application will be on our website. The application must be completed with correct documentation to be considered.