Please download and complete the release and waiver form:
Financial Hardship Assistance Fund
The financial burden on families affected by cystic fibrosis can be significant.
Often, for reasons beyond control, financial obligations can lead to distress. The Boomer Esiason Foundation is committed to providing individuals and families with the assistance needed to achieve stability in times of need. BEF’s goal is to be a temporary resource when its most critical. Sometimes things happen for which you cannot plan. If you are in financial hardship and can’t meet your obligations, please consider applying for BEF’s Financial Hardship Assistance Grant to alleviate the stress and to help to get back on track.
This program is made possible by the generosity of the Caruso Family Foundation.
Eligibility Checklist
- I (or the person I am applying on behalf of) has cystic fibrosis
- I am a US citizen or legal permanent resident of the US
- In financial hardship and cannot meet my financial obligations
Application at a Glance
- Demographic information
- Latest fiscal year W-2 tax forms for patient and patient’s family (if applicable).
- Proof of cystic fibrosis diagnosis from physician
- Photo Identification
- Detailed information describing financial need
- Detailed description for government subsidized health or assistance benefits if applicable (Medicare, Medicaid, etc.)
- Signed copy of release and waiver form
FAQS
BEF does not make direct payments to grantees.
Yes, however, there are limitations for what BEF can assist with.
For any questions please contact cmcewan@esiason.org