Apply For Assistance

Application and Medical Eligibility Requirements.

Disclaimer: By completing this application, the applicant (or parent or legal guardian on behalf of a minor child applicant confirms the waiver and liability release has been received, reviewed, and signed. The applicant further acknowledges that, in order to participate in the Dysphagia Outreach Project, the applicant must reside in the United States or its designated territories and have had a medical appointment within the last three (3) months. Eligibility for assistance may be limited based on financial need generally determined using the recipient's home state Medicaid eligibility requirements.
Name, Relationship, Address, Email, and Phone #
Please include full name, business address, and phone #
Example: Stroke, Multiple Sclerosis, ALS, Down's Syndrome, Premature Birth, Failure to Thrive, etc....
Click or drag a file to this area to upload.
(Failure to include instrumental swallow evaluation [MBSS/FEES] may result in delayed application processing.)
(Proof of income is required.)
Click or drag files to this area to upload. You can upload up to 5 files.
(Failure to include proof of income may result in delayed application processing.)
Select all that you are requesting
(attaching treating doctors order/prescription, if available in next space)
Click or drag a file to this area to upload.
* I acknowledge that I understand how to contact The Dysphagia Outreach Project with questions, concerns, or to request more supplies.

Welcome to the DOP Food Bank!

The Dysphagia Outreach Project is a 501(c)(3) nonprofit organization whose mission is to provide meaningful assistance to individuals affected by dysphagia.

To facilitate this mission, we aim to collect and distribute dysphagia supplies to individuals in need, establish a dysphagia awareness advocacy program, provide education services relating to appropriate prescription and use of dysphagia supplies, and assist in establishing a network of interconnected dysphagia support groups across the country.

Since dysphagia affects individuals at any age, our goal is to advocate for support and awareness of issues related to dysphagia across the lifespan. We also aim to improve interdisciplinary team-building and cooperation to ensure that individuals with dysphagia, their family/caregivers, and their care team are all educated regarding evidence-based practice in swallowing and swallowing disorders.

It All Started When…

Several years ago, our founder Hillary Cooper noticed a disturbing trend amongst her patients with dysphagia. Many patients were not able to afford to purchase the dysphagia supplies they needed to be successful in the home environment and often just went without items such as thickener, dysphagia treatment equipment such as respiratory muscle strength trainers, and adaptive equipment that would keep them from needing modified diets. More often than not, Hillary found herself purchasing these items for her patients out of her own pockets, as do speech-language pathologists around the country.

Hillary found herself wishing there was such a thing as a food pantry for people with dysphagia. After searching high and low, she realized that nothing of the sort existed and she knew she was meant to create one. But self-doubt kicked in and she felt that it was too big of a project for her to do alone. So it sat in her head for years.

Eventually, Hillary found herself surrounded by some amazingly inspiring speech-language pathologists and felt that the time was right to see if her idea of a dysphagia food bank was doable. She raised the idea to this group and every single person in the room jumped up from their seats in excitement at the concept. And thus The Dysphagia Outreach Project was born.

Hillary formed a board of directors, fought through the nonprofit incorporation process, and after more than a year of endless hours of behind the scenes work by our amazing team, adapting our mission statement to include education and advocacy, the contributions from amazing companies, and the support from volunteers across the country, The Dysphagia Outreach Project is now a reality.