St. Jude Medical uses an online submission process to objectively evaluate each patient assistance product donation (PAPD) application we receive. If you wish to request a grant, please select the appropriate link below the Grant Application Types heading.

For more information about our Patient Assistance Product Donation (PAPD) Program, read our Frequently Asked Questions.

To submit a grant application, select the link below and you will be taken to the Web site for the online application system. The online application system will require you to upload the following document with your grant applications: 

• Request letter on your organization's letterhead on behalf of the implanting/requesting physician. The request letter must include the following information:
• Donation purpose and confirmation of indigent patient status. 
• Explanation of application and consideration of Donation, stating that neither the physician nor his/her agent, affiliate will resell the product(s).
• Agreement that any unused product shall be returned to St. Jude Medical
• Physician to state the donation of his/her services to implant device (No Surgery Charge)
• Physician to state hospital/facility utilized is also donating services (No Hospital Charge)

Sample Letter of Request

Remember – We must receive your completed patient assistance product donation grant application, including all required documentation prior to the require date listed below:

• Minimum five business days for products that will be implanted within the United States*
• Minimum 60 business days for products that will be implanted outside the United States to assure that there is sufficient time for approved product to move through customs.

*For requests regarding product that will be implanted in the United States, an Application must be submitted at least 5 days and no more than 30 days in advance of the procedure, unless an exception is made as described below.

In the rare event of a medical emergency or similar compelling reason requiring immediate use of an SJM product which may be eligible for donation by SJM for an implant to occur within the United States, an Application may be submitted up to 5 days after the implant of the product. However, the requestor must demonstrate why the Application could not be submitted prior to the implant procedure, and the Application will go to the Grant Committee for review using the same process and criteria as with any other request. The fact that the product has already been implanted will have no bearing on the Grant Committee’s decision, and the applicant bears the risk that the Application may be denied.

Patient Assistance Product Donation Grant Application Types

Includes: Grants to request St. Jude Medical product donations to benefit indigent persons who do not have or qualify for insurance, governmental assistance or other sources of funding.

Eligibility: The product donation must be for use by indigent persons and should be from a bona fida charitable organization, such as non-profit 501(c)(3) entities.

Patient Assistance Product Donation (Domestic) Application Form
This form is to be used for products that will be implanted within the United States.

Patient Assistance Product Donation (International) Application Form
This form is to be used for products that will be implanted outside of the United States.

If you have questions, please read our Frequently Asked Questions or send a message to sjmgrants@sjm.com.