Apply

Gill Children’s Services provides assistance for children when all other resources have been exhausted. If you have exhausted all other resources for your child, please fill out our downloadable application and mail or fax to our office.

Documentation is required for the below service requests. Income verification must be presented with all application to be processed.
Birth Certificates		Dental/Oral Health
Gill requires a referral letter from the agency requesting the birth certificate. Parents/Guardians must provide a picture ID in order for the application to be submitted.		Gill requires 10-14 days to process oral health applications. All information from the referring agency/dentist is required at the time of the application.
Prescriptions		Diapers
Gill requires the original prescription in order to process prescription requests.		Gill requires identification with the child’s name and date of birth to obtain diapers (birth certificate, Medicaid card, shot records, etc.).
Special Therapy & Equipment
Gill requires a letter of medical necessity from the referring physician.