Contacts

2206 N. Main Street #223

Wheaton, IL 60187

contact@RESCUfoundation.org

800.374.9215

Medical Aid Request Form

Are you already familiar with how RESCU works?

Please learn How RESCU Can Help 

 

Then, go ahead and download the Medical Aid Request Form! Click on the link below to view and download. Then fill it out and submit by fax or mail, along with copies of all pertinent medical bills … you’re well on your way!

We know that filling out forms isn’t fun. Please know that we would rather have your Medical Aid Request Form, even incomplete, than not at all. Once we have your form, our Aid Intake will reach out to you and help fill in the gaps. If you have any questions or concerns while filling out your Medical Aid Request Form, please reach out to us. Call us at 800.374.9215 and leave a message. Someone will call you back, prepared to help.

The faster we get all the paperwork done, the faster we can help you!

Mail to:
RESCU Foundation, Inc.
2206 N Main St. #223
Wheaton, IL 60187

 

Or fax to:  888-299-9513

We know it seems like it would be easier to email paperwork to us, but, please do not.  We take our HIPAA compliance responsibilities very seriously, and your personal information is not secure through email channels.

  • The RESCU Foundation Medical Aid Panel is able to consider the following for disbursement:
  • Any bill or estimate from a licensed medical care provider
  • Any receipt or estimate for prescriptions
  • Any receipt or estimate for medical equipment
  • Excessive travel expenses for medical treatments, excluding meals
  • A Festival or Show income loss due to a medical issue
  • Limited situations of Hardship while in recovery

Please remember to include any or all of the above, with your Medical Aid Request Form.