ALS Financial Assistance Program

We are accepting applications for the February 1st, 2024 – July 31st, 2024 funding period starting February 1st.

ALS Northwest is fortunate to be able to offer financial assistance to people living with ALS in Oregon and the lower six counties of Southwest Washington. Like our other programs and services, the financial assistance program is funded by community support and our annual fundraising events such as the Walk ALS.

There are two separate funding periods offered to all people living with ALS in our region every year. The maximum reimbursement amount for one funding period is $500. This allows us to potentially reimburse up to $1,000 of qualified ALS-related expenses for each person living with ALS in our area in a single fiscal year (February 1 - January 31). The first funding period runs from February to the end of July, and the second is from August to the end of January.

Financial Assistance Program Process

How to Apply

A new application is required for each separate funding period. Once a completed application is received, ALS Northwest will respond within 2 weeks to communicate applicant approval status. If approved, we will send an approval notice, reimbursement forms, and a list of eligible expenses.

Access the application below:

English: ALS Financial Assistance Program Application

Spanish: Solicitud de Programa de Asistencia Financiera de ALS

Applications may be submitted via:

  • Email to careservices@alsnorthwest.org
  • Fax to (503) 296-5590
  • Text to (503) 512-5141
  • Postal mail to:
    ALS Northwest
    825 NE Multnomah Street, Suite 940
    Portland, OR 97232

Reimbursement Requests

Once a person living with ALS has been approved for the current funding period of the Financial Assistance Program, they must complete the one-page Reimbursement Form. Certain expenses require additional forms:

  • Mileage Reimbursement Form – Required for mileage expenses for travel to and from ALS medical appointments.
  • Respite Reimbursement Form - Required for respite care expenses. Respite care is care provided by someone other than your primary caregiver to give them some time off.

Lastly, awardees must attach receipts for all eligible ALS-related purchases and expenses. All receipts must be dated within the current funding period; the date range will be included at the top of the reimbursement form.

NOTE: Please review the Eligible Expense list before submitting your reimbursement request. This list will be sent to you along with the reimbursement forms if your application is approved. 

Only applicants approved for the current funding period of the Financial Assistance Program may submit reimbursement requests. 

If you have been approved and need a copy of the reimbursement form, please contact us at careservices@alsnorthwest.org.

Reimbursements may be submitted via:

  • Email to careservices@alsnorthwest.org
  • Fax to (503) 296-5590
  • Text to (503) 512-5141
  • Postal mail to:
    ALS Northwest
    825 NE Multnomah Street, Suite 940
    Portland, OR 97232

Once we have received reimbursement paperwork, we will mail awardees a check within the following 2 weeks. Awardees may submit all $500 worth of eligible expenses at once or submit multiple reimbursement forms and receipts until they have reached the $500 total. 

Frequently Asked Questions