Get ready to apply
A Week Away Foundation
A Week Away Respite Program
What you get
A free break, usually a week, with lodging, activities, ground travel and trip expenses. Possible help with lost wages and household bills. Open now.
- Who starts it
- You, with a letter from your doctor
- How it’s sent
- Online, on their website
- Your time
- About 30 minutes, plus waiting for the letter
- Last checked
- Aug 27, 2026
Before you start, check you fit
- Active treatment required, though recently concluded treatment may be considered; hospice is not served.
- Residence limited to 15 published Pennsylvania counties.
- Trips generally remain within 500 miles of home or hospital; air travel is not coordinated.
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Ask your doctor for the letterStart here. This is the part that takes the longest.
A Week Away Foundation needs a letter from your doctor. It has to cover 3 things. Copy this message, or say it in person at the next visit.
Hi [doctor’s name], We’d like to apply to A Week Away Foundation’s A Week Away Respite Program. They offer a free break, usually a week, with lodging, activities, ground travel and trip expenses, and they are taking applications now. They need a letter from you. It has to cover why our child will benefit, our child full name, and our child date of birth. Their form and instructions are here: https://aweekaway.org/your-week-away/ Could you write that when you have a chance? I can send you the link, or bring a printout to our next visit. Thank you for everything you do for us. [your name] · [phone]
Copying is the only thing this page does with your text. Nothing is saved. -
Fill in their applicationIt is on their website.
Open their application ↗ Checked Aug 27, 2026What the form asks for
Patient applicationContact person first name, last name, phone number, email, and relationship to patientPatient first name, last name, email, and date of birthOptional patient ethnicity, race, and gender identityPatient home address and county of residenceDoes the patient have health insurance? Patient primary insurance companyDriver license information for patient or parent/guardians: name, state, license number, expirationDo attendees have physical limitations or require special accommodations including nursing care? If yes, explainTwo preferred travel months and preferred travel yearFirst and second choice destinationsNumber of additional attendees; for each: name, birth date, phone, email, relationship, T-shirt sizeDetailed description of the patient's current situation and how it has affected the family and care team. Why do you feel a respite through A Week Away should be grantedHave the patient or any family members previously participated in a Dream, Wish, or any other similar program within one year of submitting this application? If so, please describeAre you applying for opportunity cost coverageOptional CaringBridge or Facebook story linkPrivacy Notice / Policy acknowledgment and typed signatureProperty Use Agreement & Waiver of Liability acknowledgment and typed signatureIs there anything additional you would like to addMedical-professional application · your care team fills this inMedical professional name, title, organization name/address, phone, and emailPatient first name, last name, and date of birthWhat is the patient's official diagnosis and date of official diagnosisPatient's most recent surgery or treatmentDoes the patient require special accommodations or nursing care? ExplainDoes the patient have physical limitations? ExplainHow does the patient's medical condition affect their ability to travelHow did you find out about A Week AwayMedical-professional signature / print full nameHave ready
- Copies of insurance cards.
- Valid identification.
- If requesting opportunity costs: pay stubs, W-2, and financial statements; transmit only by program-approved secure method.
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Submit it on their websiteSend the letter with your application, or the way they ask.
- Submit patient and medical forms separately; provide later documents only via the channel staff supplies.
After you send
Staff requests additional documents after initial forms. Decision is published as 7–10 days after all requested information is received. If you have not heard back by then, write and ask.
