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Thread: ntaf invoices standing frame, fes bike

  1. #1

    ntaf invoices standing frame, fes bike

    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?


  2. #2
    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
    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
    The test of success is not what you do when you are on top. Success is how high you bounce when you hit the bottom
    --General George Patton

    Complex problems need to be solved collectively.
    ––Paul Nussbaum

  3. #3
    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...

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