Uber Eats/Instacart Gift Card Request Form

Requests for gift cards are accepted from families in the Houston area who have previously applied for and received financial assistance from Addi’s Faith Foundation. To apply for financial assistance click HERE. Gift cards are meant to support families that are in the hospital for treatment, so please only apply during admission or when an admission is scheduled. Requests may be submitted once per month. Gift cards are distributed weekly. Please allow 1-3 days for an electronic gift card to be received via email.

Please enable JavaScript in your browser to complete this form.
First and Last name of person completing the form
Child's First and Last Name
Please select either “Uber Eats” or “Instacart”
Have you previously applied and received financial assistance from Addi’s Faith Foundation?