To apply by mail, download our paper application and mail the completed documents to:
The Assistance Fund
4700 Millenia Blvd, #410
Orlando, FL 32839
To apply by phone, contact our patient advocates at (855) 845-3663. We’re available Monday through Friday from 9:00Am–6:00PM EST, and we’d love to help you apply!
- There is a maximum of 5 attachments.
- Each file can be no larger than 4 MB.
- Acceptable file types: .doc, .docx, .xlsx, .xls, .pdf, .jpg, .png, .txt
- File name can not be larger than 30 characters.
The file you have tried attaching is too large. (4 MB limit)
The file you have tried attaching is an invalid file type.
There was an internal system failure with upload, please try again.
The file you are attempting to attach has a file name that is too large. (MAX 30 CHARACTERS)
You have reached the maximum number of attachments you are able to upload.
The number of files you are attemping to attach at one time would put you over the limit of 5 files.
The file name you have tried attaching has already been attached.
If you are experiencing technical difficulty or need assistance uploading documentation, please contact a Patient Advocate Monday-Friday (855) 845-3663 9 am - 6 pm ESTOr, online chat if agents are available.