Epilepsy Travel Assistance Fund

The Epilepsy Foundation is pleased to be able to offer the Epilepsy Travel Assistance Fund (the “Travel Fund”) in partnership with SK Life Sciences, Inc. 

Please do not submit this application to request a Ride-Share Voucher. 

This program offers reimbursements within the United States and Puerto Rico of up to $2,500 or $3,000¹ annually for travel expenses related to FDA-approved medical care or treatment for epilepsy/seizure diagnosis when a financial burden for travel exists and you must travel 50 miles or more from home for treatment. The Travel Fund will consider one trip at a time for an applicant; however, if the Fund has adequate resources, multiple requests can be made over twelve months to a maximum of $2,500 for an individual ($3,000¹ for those who qualify). To be eligible, individuals must have an income equal to or below 400% of the federal poverty level issued by the United States Department of Health and Human Services for the current year. 
(Unsure whether you are at 400%? Visit the FPL Calculator.)

¹To be eligible for the $3,000 reimbursement, you must require adult supervision or a travel companion accompaniment or reside in a federally defined rural area more than 50 miles from the nearest Epilepsy Center.  

You can submit your request for reimbursement to the Epilepsy Foundation using the form below. If you have any questions, you can speak with an Information Specialist by calling 1-800-332-1000, option 1, Monday through Friday, 9:00 AM ET to 5:00 PM ET. Incomplete submissions will not be accepted.

Before you begin your application, please review the information you will need:

• Copy of your most recent federal tax return.²  If you are married while living in the same household, and filing separately, submit both federal tax returns. Your combined adjusted gross income will be used to determine your eligibility.
• Letter from your physician confirming the need for treatment, details of treatment(s) you received, reasons for travel, and the treatment dates. This letter must be on your physician's letterhead, signed by your physician, and addressed to the Epilepsy Foundation within 30 days of the treatment and application. We cannot accept generic letters or letters addressed to other organizations.
• Your physician’s name, office name, address, and phone number. You will be asked to enter a brief description of the medical treatment.
• Receipts for approved travel expenses, which include:
  • Air, rail, or bus fare for standard accommodations.
  • If you drive, mileage will be reimbursed at $0.35/mile using the shortest route between your home and the medical facility or lodging address, whichever is closest. If you use a rental car, you may not claim mileage.
  • Hotel/lodging expenses.
  • Cab fare/rideshare expenses to and from the airport, bus station, or train station to the medical facility or lodging; or lodging to the medical facility.
  • Tolls.
  • Parking.
• Total amounts in each area (If you do not have an expense, you will enter a Zero (0) in the box):
  • Mileage at $0.35 per mile (reimbursed using the shortest route between the home and the medical facility or lodging address, whichever is closest). If you use a rental car, you may not claim mileage.
  • Taxi/ride share costs.
  • Airline ticket expense.
  • Bus ticket expense.
  • Train ticket expense.
  • Lodging expenses (room only, no amenities).
  • Toll expenses.
  • Parking fees.
  • Other expenses - you will need an explanation and are not guaranteed to be covered.
  • Total of all expenses.
• If you are eligible for a travel companion, you must submit their name, address, phone number, and email address.
• Upload your supporting documents
  • Combining your documents and receipts into a single PDF file is the easiest way, requiring you to only upload one document with your application.
  • If you cannot combine your files into a single PDF document, you can attach multiple documents to the application by choosing the file, giving it a name, and clicking "add file" for each document until all files are attached. You must do this BEFORE you click submit.
• Read and agree to the disclosures:
  • I understand this application MUST be completed by individual with epilepsy requesting travel assistance. Applications on another person's behalf will not be accepted unless you are completing the application on behalf of a minor in which you are the legal guardian or the doctor's letter notes the individual is cognitively unable complete the application on their own.
  • I declare that I have not requested reimbursement from any other organization for these expenses. I further declare that the information provided on this application for financial assistance is accurate and complete to the best of my knowledge and is being provided to the Epilepsy Foundation to receive reimbursement for travel expenses related to seizures/epilepsy-related medical services. I understand that the maximum amount awarded per individual within twelve months is $2,500 (or $3,000 for those who qualify).
  • The Travel Fund will consider one trip at a time for an applicant; however, if the Fund has adequate resources, multiple requests can be made over twelve months to a maximum of $2,500 for an individual ($3,000 for those who qualify).
  • All documentation must be submitted no later than 60-days after the date of treatment.
  • I understand that I may be required to provide evidence of the submitted information and authorize the Epilepsy Foundation to contact the appropriate medical practitioners or services to verify services.
  • I understand that the Epilepsy Foundation of America will only issue reimbursement to the individual listed on the application if approved and is not responsible for monies owed to third party vendors for transportation.
  • I agree to allow the Epilepsy Foundation and SK Life Sciences to use my name in Travel Assistance Fund award announcements and related publications.

If you have any questions, you can speak with an Information Specialist by calling 1-800-332-1000, option 1, Monday through Friday, 9:00 AM ET to 5:00 PM ET.

Please do not submit this application to request a Ride-Share Voucher. Applications for Ride-Share Vouchers are no longer being accepted.

Click here to submit an application

²If you are currently unemployed, or do not file taxes, you may submit one of the following documents instead of a recent tax return. Proof of income is subject to verification:

1. Affidavit of No Income (notarized): A sworn statement confirming that you have not received earnings during a specified period.
2. Letters from Public Benefit Agencies: Government assistance programs generate official records verifying your financial status.
3. Verification Through Tax Transcripts: Tax transcripts from the IRS provide an official record of reported income.
4. Employment Verification Letter: If you have a job offer, you can provide a signed offer letter.
5. Tax Returns: These documents can serve as proof of income.
6. Official Statement/Letter from a CPA or Trust Manager: A professional can verify your financial status.
7. Bank Statements: Check your bank account statements for a record of funds.
8. College Financial Aid Documents: If you are a student, you can provide documents related to financial aid.
9. Guarantor: If you have a guarantor, they can vouch for your financial situation by submitting a notarized affidavit about your financial status.