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Responder Access to Care Grant Request Form

You’ve just taken a brave and meaningful step — and I’m so glad you did.

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​Thank you for your interest in the 2nd Alarm to Second Wind Access to Care Grant Program. These grants are designed to help first responders and their spouses access counseling, trauma-informed treatment programs, and responder-focused retreats when financial barriers might otherwise prevent care. 

 

All information submitted will be kept confidential and used only for the purpose of determining eligibility for grant support.

California First Responder Counseling
Responder Affiliation Required
Which type of support are you seeking? Required
Have financial considerations made it difficult to access this support? Required
Have you applied for or received funding from any other organization for this service? Required
Have you used all EAP sessions offered through your department? Required

2nd Alarm to Second Wind respects the privacy of all applicants. Information submitted will remain confidential and will only be used for grant determination purposes.

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By submitting this application, I confirm that the information provided is accurate to the best of my knowledge. I understand that grant awards are not guaranteed and are dependent on available funding.

 

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this electronic messaging and wish to continue despite those risks. By clicking "Submit" you agree to hold 2nd Alarm to Second Wind and Kristina Cook, LPCC harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

Thanks for submitting!

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Mental health support for first responders
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2nd Alarm to Second Wind Foundation, Inc

501(c)(3) nonprofit organization to which contributions are generally tax-deductible to the extent allowed by law.

401 Boyd Street, Vacaville CA 95688

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