ntaf invoices standing frame, fes bike

[freedomdan]

How do I go about getting an easy stand glider standing frame, estim unit, estim bike with NTAF once the money is there? Thanks.

Invoices....Where/how can i get/send an invoice to ntaf with my shipping address so that the glider is purchased and sent to me asap?

thanks.

[PN]

NTAF Catastrophic Injury Program
A special program of National Transplant Assistance Fund
150 N. Radnor Chester Road, Sui te F-120, Radnor , PA 19087
800-642-8399 rophicfund.org
CATASTROPHIC INJURY FUND REQUEST FORM
Please use this form when requesting funds from an NTAF Regional Restricted Fund.
Note the following guidelines:
• Requests must be in writing with a separate form for each different billing address
• Requests must be broken down by category of expense with the total on this form
• Requests are to be for medically related expenses
• All requests must be accompanied by backup receipts and mailed, not faxed, to
NTAF by Tuesday for processing that week
Date: _______________________________
Fund Name: __________________________________________________ ____________________________
Patient’s Name: __________________________________________________ _________________________
Requested by: Name: __________________________________________________ ________________
Address: __________________________________________________ ________________
Phone: __________________________________________________ ________________
Email: __________________________________________________ ________________
Amount Requested: __________________________
Payable to: Name: __________________________________________________ ________________
Send to: Name: __________________________________________________ ________________
Address: __________________________________________________ ________________
Phone: __________________________________________________ ________________
Itemize Expenses by Total in Each Category:
Medical: ___________________________ Home Access: ______________________________
Receipts Yes ___ No ___ Receipts Yes ___ No ___
Home Care: ________________________ Transportation: ____________________________
Receipts Yes ___ No ___ Receipts Yes ___ No ___
Medical Equip.: ____________________ Other: ______________________________________
Receipts Yes ___ No ___ Receipts Yes ___ No ___
Explanation/Comments (if necessary): __________________________________________________
__________________________________________________ _________________________________________

Important Reminder:
Please include proof of medical treatment received during travel
(e.g.: doctor’s note, parking receipt, invoice from treatment)
Rev 01/08- Form Folder/FUND REQUEST FORM

[freedomdan]

okay this i was guessing thats what to use. im not looking for a fund request personally, but i guess you send this form to the company...