Policy: The assistance program has the right to have “open and closed” periods, based on availability of funds. Patients currently receiving monthly assistance will not be dropped, but new patients will not be accepted during this time.
Applications must be faxed or emailed to NMF from your healthcare facility, by your doctor or patient advocate. Application must be completed in full and each applicant may renew monthly. The monthly renewal form must also be sent from your healthcare facility, by your doctor or patient advocate.
Download application HERE.
Download renewal application HERE.
Any misleading information provided in the application will automatically terminate qualification for financial assistance.
Nikki Mitchell Foundation assists with multiple financial services, depending upon the need. Services include, but are not limited to: gas and grocery cards, meals delivered, house cleanings, travel expenses to and from treatment, utility and phone bills, among others. Phone bills that include cable will not be considered, and a breakdown of the actual cost of the phone line is required.
If the patient is approved for financial assistance, assistance will be sent out within one week directly to the patient or creditor.