Project/Patient Assistance Grant – SIX-MONTH PROGRESS REPORT

Grant recipients are required to submit a progress report about the first six months of operation. The report must follow the format below, and must be submitted electronically by October 15, 2021 at 11:59 PDT.

As you will see below, this form also serves as a vehicle to request project and budget amendments, and to request a deadline extension. These requests should not be made lightly. The Hemophilia Alliance Foundation Board expects projects to be completed in the grant-year timeline. However, we recognize that unanticipated circumstances may arise, and for this reason, we will entertain requests for project, budget, and/or deadline changes.

The Hemophilia Alliance Foundation Board recognizes that 2021 brought challenges that may require project, budget, and/or deadline changes.

IF YOUR PROJECT HAS BEEN COMPLETED BY OCTOBER 15, 2021, YOU MAY FORGO SUBMITTING A PROGRESS REPORT AND SUBMIT YOUR FINAL REPORT BY OCTOBER 15, 2021.  THE FINAL REPORT FORM IS AVAILABLE ONLINE ON THE FOUNDATION WEBSITE.

  • 1. Contact information
  • 2. Briefly describe the progress of your Hemophilia Alliance Foundation grant project and/or patient/consumer financial assistance.*
  • 3. Briefly describe any unanticipated hindrances to the project.*
  • 4. Briefly describe your expectations for the project’s completion.*
  • 5. Do you anticipate having any unused funds from this project?*
  • 6. Generally, funds remaining at the end of the grant will be returned to the Alliance Foundation. However, if there were hindrances to the project that were out of your control, you may request an extension of up to six months. Do you anticipate:
  • Note 1: After clicking the "Submit" button below, a notification email, along with a link to a PDF of this form submission, will be sent to the email that you've entered into the "Email for contact person" field. However, the PDF can only be accessed from the same computer that was used to submit this form. This is a security measure to prevent unauthorized downloads. Therefore, if you're submitting this form on behalf of someone else and have input their email address into the "Email for contact person" field, then they'll need to email the PDF link to you so that you can access it from your computer.
  • Note 2: If, after submitting the form, you don't receive a notification email in your Inbox, then please check your spam folder and whitelist the email address "info@hemophiliaalliancefoundation.org".