This diagnosis must be reflected in a Verification of Diagnosis, or VOD that is included in the grant paperwork. This form must be signed by a medical professional.

SDS defines a traumatic or acquired brain injury as “an insult from physical force or internal damage to the brain or its coverings, not of a degenerative or congenital nature, that produces an altered mental state and that results in a decrease in cognitive, behavioral, emotional or physical functioning (AS 47.80.590).”

• Medical services (including vision, hearing, psychological testing, medication, and occupational, physical or speech therapy, when prescribed by a health care professional) and equipment.
• Dental services and equipment
• Assistance with rent, housing deposit or utility (heating/fuel or electricity) payment. Rental assistance and utility assistance is a once-per-lifetime award.
• Employment related services and supports
• Other equipment or services that improve the health, safety, or independent functioning and are directly related to the applicant’s brain injury.

You can apply for the grant by printing out the application at the bottom of this page and returning it to Alaska Brain Injury Network. Your health care provider will need to complete and sign the Verification of Diagnosis form. Be sure to provide invoices or statement of expenses for each item you are applying for. This is because award payment is rendered directly to the vendor.

You will need to submit the following documents each time you apply:

• Application page (signed and dated)
• Verification of Diagnosis
• Release of Information
• Price quotes

Applications are due the last business day of each month.

When everything is complete you can fax the application to 907-274-2826, attention Tyler Hislop or mail to:

Alaska Brain Injury Network
121 W. Fireweed Lane, #175
Anchorage, AK 99503

If have questions about the grant or need assistance with the application, please contact Alaska Brain Injury Network at 907-274-2824. Please note that we may have some of your application materials on hand if you have applied for the grant before.

A decision is made on the grant applications in the first week of the month following the deadline. Payment can be expected to be rendered by mid-month.

Please contact 274-2824 or 274-2822 with your questions.