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 our control, financial obligations can lead to distress. The Boomer Esiason Foundation is committed to providing individuals and their 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. Unforeseen situations may include a natural disaster, an organ transplant, a sudden loss of job/wage or a medical emergency. 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 you 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
- Proof of cystic fibrosis diagnosis (and transplant status, if applicable)
- Include a letter from physician (on letterhead) confirming CF diagnosis
- Detailed description for government subsided health or assistance benefits if applicable (Medicare, Medicaid, etc.)
- Detailed information describing financial need
- Latest fiscal year w-2 tax forms for patient and patient’s family (if applicable)
- Signed copy of release and waiver form
- Photo identification
FAQS
No. Once an award is provided, the grantee will no longer be eligible for additional assistance from this program.
Yes. BEF may request additional documentation regarding your transplant status.
No, BEF will not help with medical expenses related to an organ transplant.
BEF may assist with temporary housing or relocation costs.
No. BEF only makes payments to third parties.
No. BEF only makes payments to third parties.
No. BEF will not help with medical or health insurance-related expenses.
Yes, however, covered expenses may be restricted depending on the state in which the applicant resides.
No. Eligibility is limited to U.S. citizens.
Once an application is completed and submitted, BEF will process it within three to four weeks.
For any questions please contact cmcewan@esiason.org