Assistance Application

Financial Assistance is available to cystic fibrosis patients who attend a qualified cystic fibrosis care center.

Eligibility Guidelines

• Patient is diagnosed with Cystic Fibrosis.
• Patient is followed by a qualified cystic fibrosis care center.
• Evidence of financial need.
• Patient and/or family has explored other options of financial assistance.

Application Procedure

• Download and complete the entire application.
• Provide documents to support the requested assistance. Copies of the CURRENT bill and/or EOB (Explanation of Benefits) must be attached.
• Do not leave any field blank. If it does not apply, please put n/a.
• Incomplete request or missing information will be automatically denied.
• Send completed application to the social worker at the qualified cystic fibrosis care center.
• DO NOT CONTACT Reaching Out Foundation Directly.
• All request will be reviewed and approved by the social worker. The Foundation has the final approval.
• The requesting social worker will be notified regarding the review decision. Please allow 5 business days after the CFROF receives the application to process the payment.
• Checks are only written and paid directly to the vendor.
• Reaching Out Funds should be used as a last resort. Social Workers are required to review all request for alternative funding.
• Genetic testing, funeral expenses, collection agency bills and credit care bills are not covered. We also do not pay late fees. The non-covered list is not all inclusive. Other request may be denied by the board. Request may not be approved due to lack of funding.
• Dollar limits apply.