COVID-19: CF Patient Assistance Program

This program was created to lighten the financial burdens that people with cystic fibrosis are facing due to the COVID-19 pandemic.

PROGRAM GUIDELINES

The financial support provided by this program will be available for people living with cystic fibrosis and their families who are struggling to pay for:

  • mortgage/rent
  • food
  • transportation
  • home schooling needs
  • cleaning products
  • self protection (masks, hand sanitizer, etc.)

 

This grant will not cover:

  • medical related expenses including but not limited to medications and medication co-pays
  • insurance

THIS IS NOT A REIMBURSEMENT PROGRAM.

DIRECTIONS FOR APPLYING FOR COVID-19 RELIEF:

  • Applicants must complete an official application.
  • A letter from the patient’s social worker/physician stating:
    • the patient has cystic fibrosis,
    • how much money is needed,
    • and where the funds should be allocated.
    • A statement explaining why the patient is in need of funds (i.e. loss of wages, loss of job, etc.

*Please specify reasons for relief. The more detail this letter provides, the more attention the evaluation committee will give your application.

  • Please include invoices where applicable.

*Note – grant payment will be made directly to third parties only in a one time payment. Grant allocation conditions may vary.

**BEF reserves the right to request more documentation.

Please email Chris McEwan (covidrelief@esiason.org) or call 646.292.7939 if you have question about the program or would like to make a donation.

APPLY ONLINE:

COVID-19 Relief Application

  • MM slash DD slash YYYY
  • Additional Documentation

  • Drop files here or
    Max. file size: 512 MB.

    OTHER WAYS TO SUBMIT YOUR APPLICATION:

    You can send the application form in one of three ways:

    Please download and complete the application form:

    Mail the completed form and supplemental materials to:

    Boomer Esiason Foundation
    Attn: Chris McEwan
    200 B Armstrong Road
    Garden City Park, NY 11040

    Email the completed form and supplemental materials to:

    Fax the completed form and supplemental materials to:

    516.746.4437