Sheffield Area Kidney Association - Grant application form

Grant application form

SAKA

SAKA is here for you. We help all kidney patients covered by the Sheffield Kidney Institute, along with families and friends.

Feel free to contact us for further information, to make any suggestions for what we could do for kidney patients or if you need any help.

Email:

contact@saka.org.uk

Phone SAKA Secretary:

07719 787885

SAKA Facebook Group

Patients (and family members, friends, carers etc) who attend the Sheffield Kidney Unit or its satellites are invited to join this small confidential Facebook Group to share news and information.

Click the link below to visit/join:

https://www.facebook.com/groups/sakasheffield

Tweet this page

Please fill in the form below to enquire about getting financial assistance from SAKA. We will get back to you as soon as possible. If we think we can help we may require more details, or we may signpost you to other sources of help.

If you have difficulty filling in the form, please send an email to:

treasurer@saka.org.uk

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SAKA Enquiry form

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Name: *

Address *

Post Code *

E-mail address: *

Phone No

Date of birth *

To decide if you are eligible for a grant the renal social workers may need details of your income and regular expenditure. Please tick the box to give permission for SAKA to pass on your details to the social work team.

Current treatment e.g. pre dialysis, dialysis, transplant etc. *

Employment status e.g. employed, receiving benefits, retired etc. *

What help do you need? *

Captcha (spam protection code): *

I herby agree that my data entered in the contact form will be stored electronically, and will be processed and used for the purpose of establishing contact. I am aware that I can revoke my consent at any time.

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