Free Developmental Screenings
Moving Mountains Foundation provides screenings for organizations including daycares and private schools and settings that may experience higher needs putting them at risk for increased densities of individuals with disabilities such as group homes or daycares with adults or children who experience poverty. Given the results of the screening, Moving Mountains Foundation makes the appropriate referral. These referrals may include a recommendation for a visit to their physician or to a specialist such as a neurologist, occupational therapist, speech therapist, physical therapist, mental health provider, audiologist, or education specialist.
Fill out the application completely and legibly. Incomplete or illegible applications cannot be processed.
Email your completed application to: firstname.lastname@example.org
Moving Mountains Foundation will respond to your email within four weeks of it being sent either requesting more information or stating whether or not your request will move to the formal decision stage.
As soon as Moving Mountains Foundation has all of the needed information from you, the case will be decided at Moving Mountains Foundation monthly board meeting.
If approved, Moving Mountains Foundation will send funding to the provider or organization (not the family) within three weeks of approval. Rx: If approved, Moving Mountains Foundation will pay the vendor (not the organization or individual) directly on behalf of the recipient.
Funds must be used within twelve months of the date granted. All unused funds will be returned to Moving Mountains Foundation.
Moving Mountains Foundation
****Complete Only The Section (S) Being Requested****
1. Request for Screening
How many screeners needed: ______________________________________________________________
Length of time: _____________________________ Population: ________________________________
2.Request for Equipment/Supplies (attach additional pages listing equipment costs and amount needed)
Type of equipment/supplies: _____________________________________________________________
Cost of equipment $_______________________________
3. Request for Travel
Purpose of travel: _____________________________________________________________________
Miles between clinic and destination: _______________________ Number of individuals: ____________