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The following eligibility criteria must be met in order to qualify for a grant:
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  1. ​Working group from each individual hospital must approve all funding requests.

  2. Patients are eligible only if hospital has waived bed charges: SLSF will not make payment to the hospital

  3. Submission of Bipanna documentation from ward office required. Citizenship of parent or birth certification required. Exemption if emergency condition exists.

  4. Cases deemed futile will not be funded: decision to be made by the Hospital Working Group.

  5. Patients need to submit proof of purchase (receipts) for funding support. This receipt will need to be signed by the treating physician. 

  6. Hospital social service recommendation is not needed.

  7. Acute renal failure patients will be lower priority due to the support program by the government  of Nepal (approval of exec committee required in emergency cases).

  8. Fund for Oncology patients will be granted for diagnosis of suspected cases (for confirmation of cancer). The government supports cancer patients after diagnosis.

SLSF Patient Funding Request Form

Patient information

Patient's Birth Date
Month
Day
Year
Patient's Sex

Funding Information

Criteria for funding:

Hospital has waived bed charge
Yes
No
Only out of hospital funding
Yes
No
Bipanna document from ward office (attach at bottom of form)
Yes
No
Citizenship of parent (attach at bottom of form)
Yes
No
Birth certificate of parent
Yes
No
Acute renal failure (if yes, needs approval from Board)
Yes
No
Patient with oncology condition (if yes, fund request for biopsy)
Yes
No
Recommended by hospital social service
Yes
No
Emergency Request
Yes
No

Medical history

Receipt signed by attending
Yes
No
Guardian consent to photos/videos
Yes
No
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