SickleCellMN COVID-19 Mask Request Form
Sickle Cell Foundation of MN (SickleCellMN) recognizes the enormous burden of COVID-19, especially for those living with a chronic illness such as Sickle Cell Disease (SCD). Though we fully support Governor Walz's #StayHome, #StaySafe order, we also recognize that many families may have necessities that require them to leave their homes for work or basic needs.

Thanks to the generosity of local donors, SickleCellMN has secured a limited number of child-sized cloth masks for warrior children and/or children of adult warriors. Mask are small/medium sized and will safely cover the nose, mouth and chin of MOST children. Each family is eligible to receive up to 3 masks.

***** Masks are not sized to safely cover or protect adult-sized faces *****

PLEASE NOTE: As a non-profit organization, we rely on the generosity of our sponsors. Program continuation is contingent on the availability of funds. The program could be modified or discontinued at any time if funding is limited or no longer available.

Sickle cell patients and caregivers are encouraged to FIRST utilize/reach out/exhaust all federal and state resources as we continues to identify resource gaps and fill community needs as we are able. Thank you for you on-going patience and support. 


REQUIREMENTS:
-- Applicant /Patient must be a FULL TIME RESIDENT in the state of Minnesota (Proof may be required)
-- Applicant must be an individual (or caregiver of a warrior child) with a confirmed sickle cell disease
diagnosis
-- Child/ren must reside IN YOUR HOME! Due to limited resources, we are unable to provide for friends and
extended family.
-- Maximum of 3 masks per household (child information required)
-- Applicant/Patients do not need to have a COVID-19 diagnosis
Email address *
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